Free COVID-19 Vaccines Remain Widely Accessible Under ACA

**Medicare: A Comprehensive Overview** Medicare is a federal health insurance program in the United States, designed to provide coverage for individuals aged 65 and older, as well as younger people with disabilities, including those with End-Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS)[1][2]. Established in 1965 under the Social Security Administration, it is now administered by the Centers for Medicare and Medicaid Services (CMS)[1][7]. **History and Structure** Medicare was created to address the healthcare needs of older Americans and those with severe disabilities. Over time, it has expanded to include more individuals and services. The program is structured into four parts: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage), and Part D (Prescription Drug Coverage)[1][3]. **Key Achievements and Current Status** Medicare has been instrumental in providing health insurance to millions of Americans. As of recent years, it covers over 66 million people, with more than 57 million being aged 65 and older[1][5]. The program is funded through a combination of payroll taxes, premiums, and general revenues[6]. Medicare has been pivotal in reducing healthcare costs for its beneficiaries, though it only covers about half of their healthcare expenses[1]. **Notable Aspects** - **Financial Impact**: Medicare spending is substantial, with billions of dollars allocated annually[1]. - **Technological Integration**: CMS contracts with private entities for services like claims processing, which integrates technology into the program's operations[7]. - **Expansion and Innovation**: Medicare continues to evolve, offering various plans and benefits to meet diverse healthcare needs[4]. In summary, Medicare is a critical U.S. healthcare program that has made significant strides in ensuring health coverage for vulnerable populations. Its continued growth and technological advancements underscore its importance in the healthcare landscape.

Medicaid is a vital public health insurance program in the United States, designed to provide comprehensive health coverage to low-income individuals and families. Established in 1965, Medicaid is jointly funded by the federal government and each state, allowing states flexibility in designing their programs within broad federal guidelines[1][8]. ### What Medicaid Does Medicaid offers health and long-term care services to over 90 million low-income Americans, including children, pregnant women, seniors, and people with disabilities[2][5]. It is crucial for state budgets, accounting for a significant portion of healthcare spending and long-term care costs[2]. ### History and Key Achievements Since its inception, Medicaid has expanded to cover more populations, notably through the Affordable Care Act (ACA) in 2010. By June 2025, 40 states plus the District of Columbia had implemented the ACA's Medicaid expansion, significantly increasing coverage for low-income individuals[1]. Medicaid has also been instrumental in reducing mortality rates and hospitalizations among its enrollees[4]. ### Current Status Recent changes, such as the 2025 budget reconciliation bill, have introduced new work requirements for certain enrollees and reduced federal spending on Medicaid[3][4]. These changes are projected to decrease federal Medicaid spending and enrollment numbers over the next decade[2][4]. ### Notable Aspects - **Flexibility and Variation**: States have considerable autonomy in designing their Medicaid programs, leading to diverse coverage and benefits across the country[1][2]. - **Impact on Healthcare**: Medicaid plays a critical role in healthcare access for vulnerable populations and is a significant component of state healthcare systems[5]. - **Economic Impact**: Changes to Medicaid can have substantial economic implications, affecting both healthcare providers and local economies[4]. Overall, Medicaid remains a cornerstone of healthcare access for millions of Americans, with ongoing policy changes continuing to shape its role in the U.S. healthcare system.