Although the number of Medicaid elderly beneficiaries has increased from 3.1 million in 1985 to 4.4 million in 1995, the payments for these beneficiaries have more than doubled. Medicaid covered 6 million people with disabilities in 1995. Medicaid blind and disabled beneficiaries increased from 3.0 million in 1985 to 5.8 million in 1995. A growing number of States are using the authority available under current law to design and launch a wide variety of Medicaid health care reform demonstrations. The States have used this flexibility to cover more of the working poor, expand managed care enrollment, and test other innovations in the financing and delivery of services for parts or all of their Medicaid populations.
All States cover a minimum set of services including hospital, physician and nursing home services.
States have the option of covering an additional 31 services including prescription drugs, hospice care and personal care services. States' flexibility in designing their Medicaid program is highlighted by the fact that over 50 percent of Medicaid benefit payments in 1995 were for optional services and populations selected by the States. Medicaid is the largest insurer of long term care for all Americans, including the middle class. Medicaid covers 68 percent of nursing home residents and over 50 percent of nursing home costs. Medicaid covers skilled nursing facility care, intermediate care facilities for the mentally retarded and developmentally disabled, and home and community based- services.