“Medicaid’s evolution has involved significant challenges stemming from many causes—its roots in welfare; its federal-state structure; spending pressures generated by economic recessions, legislated expansions, and health care cost inflation; and deep-running ideological conflicts. But by virtue of its federal-state design and its financing structure, Medicaid has been able to respond to diverse and changing societal needs over the course of 50 years. In its expansion to fill widening gaps in health coverage, its positive impact on access to care and community integration, and its role in improving care for people with complex needs, Medicaid is largely a story of adaptability and resiliency. While uncertainties are inevitable given ongoing Medicaid policy debates, demographic pressures, and factors in the health care system overall, Medicaid’s service and record as our nation’s health care safety net bode well for future generations of Americans as the Medicaid program begins its next 50 years.”

Our Take: We wouldn’t sing high praise for the Medicaid program as these authors do. But for a thorough review of the program, this is one of the best we’ve seen.

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