Medicaid Basics

Medicaid Basics

Established in 1965, Medicaid is a jointly-funded federal and state government health care program. It is the largest provider of health care for children, seniors and working families in Colorado and across the nation.

Medicaid pays for doctors’ visits, hospital bills, prescription drugs, long-term care and other health needs if an individual or family meets eligibility criteria. Medicaid is working the way it should. When our economy does well, fewer individuals need it, and when our economy struggles and Coloradans lose their jobs, the demand for it increases. Each state has unique eligibility requirements based on income and family size. Below are a few examples of those who qualify in Colorado:

Pregnant Women
Long-Term Care
$42,642 for a family  of 4 or 185% of FPL*
$30,656 for a family of 4 or 133% of FPL*
$23,550 for a family of 4 or 100% of FPL*
$24,464 + $2,000 or less in assets per individual
$8,088 for an individual

Medicaid is more efficient than private insurance for Coloradans. The per capita cost of care for commercially insured ages 0-64 in Colorado in 2011 was $2,863, for Medicaid ages 0-64 it was $2,461–Medicaid is $400 less than private insurance!

Traditionally, Colorado’s Medicaid program has been a 50/50 match program, meaning every dollar invested by Colorado has been matched by the federal government. Thanks to recent reform efforts, Medicaid is seeing increased efficiencies and cost savings to taxpayers. Not only has Colorado been increasing coverage under this program, but we’ve also been decreasing per capita costs, and cracking down on waste, fraud and abuse.

A direct result of providing more Coloradans with secure, affordable access to health care is economic growth. For every $1 invested in new health care spending in Colorado an additional $2.44 in economic output is produced and most of those dollars will be spent locally at clinics, on medical supplies and other health services.

By the Numbers

  • 600,000 Coloradans per year  receive critical access to healthcare through Medicaid
  • 60% of Medicaid clients are children
  • 58% of adult Medicaid clients are women
  • 18% of Medicaid clients are aged and/or disabled, but represent about 58.6% of Medicaid expenses