There is a Medicaid program in each and every state. The majority of the Medicaid programs function in a very similar way. However, it appears that Rhode Island is doing something a little bit different with their Medicaid program.
Medicaid is a public, or government run, form of health insurance. It is designed to cover individuals and families who are low income and who cannot afford to buy a health plan from a private insurance company. Medicaid is partially funded by the federal government. It is also partially funded by the government of an individual state.
In Rhode Island, the Medicaid program is administered by the Rhode Island Department of Human Services. A few years ago, the state of Rhode Island got permission to do an experiment with their Medicaid program. The experiment gave the state greater flexibility in how Medicaid functioned.
An agreement between the state of Rhode Island and the federal Centers for Medicare and Medicaid capped the spending on Medicaid for the state at $12 billion through 2013. The federal government covered up to that amount of spending. Rhode Island would be responsible for covering all costs that went above that amount.
In 2009 and 2010, Rhode Island received an additional $320 million from a federal stimulus package that would be used on Medicaid. This probably helped the experiment. It seems to me that the big difference between Medicaid in other states, and Medicaid in Rhode Island, is that the state found a way to have a bit more flexibility in how it spends money earmarked for Medicaid.
Only certain groups are able to apply for Medicaid in Rhode Island. A person must be an adult with a disability, or a person who is age 65 or older in order to qualify. Families with dependent children who are under the age of 19 may also qualify.
Those deemed eligible for Medicaid will get a plan through UnitedHealthcare, a private insurance company. Most of the other states do not administer their Medicaid programs this way.
The Rhody Health Partners (RHP) plan is Rhode Island’s Medicaid managed care plan for eligible adults who have a disability and who are 21 years of age or older. Rite Care is a Medicaid managed care program for families who are on the RI Works Program. It also covers uninsured women who are pregnant, children, and parents.
There is also a Children With Special Health Care Needs (CSN) plan that covers kids who have a disability or a chronic condition. The children must be eligible for Supplemental Security Income in order to be eligible for CSN.
Image by Norman B. Leventhal Map Center at the BPL on Flickr