Hi everyone, it's Beth here for a quick primer on Medicaid and the Republican health care bill.

Regular Pantsy Politics listeners know that I have a 20-month-old daughter and a six-year-old

daughter and my girls are both with their grandparents today and I kind of got myself into a research

rabbit hole and decided spontaneously to do a primer on Medicaid and the Republican bill in advance

of Tuesday's episode in which Sarah and I are going to talk a lot about their Republican health

care proposal. So my intention is to usually have someone with me doing these primers so it doesn't

feel like I'm just lecturing at everyone but this one was spontaneous so I hope you'll bear with me.

It's really difficult to get your arms around the significance of the Republican health care plan

without some understanding of Medicaid so I want to start there. Medicaid is a program that provides

payment for health services to people based on means testing. It's the single largest source of

health coverage in the United States. It covers about 20% of US population. It finances 16%

of all personal health care spending in the United States. It was created by Title 19 of the

Social Security Act and it's administered within the Department of Health and Human Services

by the Centers for Medicare and Medicaid Services or CMS. The program is jointly administered by

the federal government and state governments so there's a national framework for Medicaid

but states have a lot of flexibility on how to pay hospitals and physicians, what populations are

covered, what services are covered, what delivery models are going to be used and states can even get

waivers to deviate from the federal guidelines to test out ideas if the Secretary of Health and

Human Services determines that those ideas are consistent with the overall program objectives.

About one in five people are eligible for Medicaid based on income. 50% of people covered by

Medicaid are children under the age of 19. 25% are non-elderly adults and 25% are senior

citizens and people with disabilities. Two-thirds of Americans report having some connection to

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