Medicaid: 50 Years of Helping People Like Me

July 17, 2015 • By Nadia Ibrahim, Public Health Analyst, Federal Office of Rural Health Policy, Health Resources and Services Administration

Last week, I took time off work for a routine medical exam. I need assistance with daily activities like dressing and bathing, but I went to the appointment alone. To the average reader, there may be nothing noteworthy about this. But, 50 years ago that would have been nearly impossible for someone with a disability, particularly for women.

Women with disabilities have faced unique challenges over the years — ranging from access to health care to employment. It's more difficult for women with disabilities to get routine care than non-disabled women, and health care providers may not have the knowledge they need to work with people with disabilities. Plus, women with disabilities are less likely to be employed than men with disabilities, and what's worse, they're more likely to be poorer than men with disabilities due to higher unemployment rates and the fact that they earn lower wages.

Fortunately, several pieces of landmark legislation — including the Social Security Act Amendments of 1965, which established Medicare and Medicaid— changed the way that I, and many other people with disabilities, live, work, and engage with our communities. Both Medicare and Medicaid celebrate their 50th anniversaries this year. Medicare provided improved health care access for Americans 65 and older and those under 65 with certain disabilities, such as end stage renal disease. Medicaid served as the health care safety net for low-income mothers and children, as well as individuals with disabilities.

These programs initially assisted with emergency care and long-term institutional services and supports, meaning people with disabilities in facilities could get help with daily activities like bathing and dressing. But over the years, Medicaid andMedicare dramatically increased their benefits, and more Americans are eligible to apply. Medicaid covers a range of services for more than 1 in 10 women, including birth control, pregnancy-related care, and long-term care. According to 2013 data from The Kaiser Family Foundation, 50% of all women with disabilities receive assistance from Medicaid.

The largest percentage of the programs' costs go to long-term services and supports. However, there is a steady shift from funding institutionalized care toward home and community-based care. Waivers, grants, and programs give states the opportunity to develop creative strategies to help people with the most significant disabilities gain better access to health care, obtain and maintain employment, direct their own care, and live independently. Still, opportunities remain for widespread adoption of these innovative strategies.

For the past 50 years, Medicare and Medicaid have provided an important safety net for people with disabilities, the elderly, and those with low incomes. But perhaps the most meaningful changes have been those that provide individuals like me the chance to maintain their physical, social, and emotional well-being through increased access to health care and employment. I'm thankful to live in a world where programs like Medicaid exist. Medicaid considers my needs and helps me live up to my full potential.