Medicaid is a critical part of the U.S. social safety net. The joint federal–state program enables millions of people with low income, including children, pregnant women, and people with disabilities, to access the health care they need. Today, Medicaid’s reach is larger than ever: the program is now the nation’s largest insurer, covering around 80 million Americans. Medicaid pays for more than two in five births, and an even greater share for people of color and people in rural areas. It’s also the country’s primary payer for behavioral health and long-term care services.
Decades of evidence shows that Medicaid facilitates access to care, improves health, and protects the financial well-being of the people it serves. Still, the program and its beneficiaries face several challenges. People eligible for Medicaid often struggle to enroll or keep their coverage for extended periods because of the program’s complex eligibility criteria and application processes. Beneficiaries also may have trouble finding providers that accept Medicaid — particularly specialty care providers — because its payment rates tend to be lower than rates paid by other insurers. Addressing these challenges, while curbing rising program costs, is a key concern for states, which oversee their Medicaid programs and, together with the federal government, fund them.
The Commonwealth Fund aims to inform policymakers’ efforts to enhance coverage, improve access to care, and advance health equity in the Medicaid program. We do so by investing in projects that:
- Track states’ expansion of Medicaid eligibility and examine the impact on coverage, state economies, and budgets.
- Monitor federal and state changes to Medicaid policy and evaluate their effects on access to care, health outcomes, and health equity.
- Provide technical assistance and state-to-state learning opportunities for Medicaid leaders.
Program Contact:
Akeiisa Coleman, Senior Program Officer, Medicaid
2025 Program Funding Priorities
- Ensuring Medicaid is meeting the needs of all enrollees.
- Improving the continuum of behavioral health services that Medicaid covers, especially for children and adolescents.
- Ensuring the sustainability of Medicaid long-term services and supports while improving access to and quality of home- and community-based services.
