What States Have Free Health Insurance for the Poor?

All states offer some form of health insurance for low-income populations. Medicaid is a jointly state and federally funded health insurance program for low-income individuals and families. However, individual states determine Medicaid eligibility criteria and coverage (working within federal guidelines), so eligibility and benefits, including copays, approved procedures and prescriptions, vary greatly from state to state.

Medicaid is a means-tested social welfare program providing health insurance for low-income people. Eligibility requirements and benefits vary by state, and all states have tightened requirements and reduced benefits in recent years. Furthermore, in 2008 a law was passed enabling states to charge larger copays to Medicaid recipients, and this is being phased in through 2012 (several states, including California and New York, have already announced upcoming Medicaid copay increases). Medicare is a fully federally funded program that provides health insurance for those over age 65 or disabled individuals. Medicare is not income-dependent, so some people are eligible for both Medicaid and Medicare (Medicare dual eligibles).

Eligibility for Medicaid includes a low income and fitting into one of the following categories: pregnant women, children and teenagers, aged/blind/disabled or a family in certain transitional situations. Note that in general, able-bodied men and women are not eligible for Medicaid despite a low income. Benefits vary dramatically from state to state, but federal guidelines assure that Medicaid patients receive customary medical care for their conditions. CHIP (Children's Health Insurance Program) is a federally administered but state-run adjunct health and dental insurance program that is available for all low-income children.

The ten states that provided the most Medicaid benefits per enrollee in 2005 were: District of Columbia, $7,941; New York, $7,733; Alaska, $7,699; Maine, $7,691; North Dakota, $7,496; Rhode Island, $7,464; Connecticut, $7,212; New Jersey, $7,022; Minnesota, $6,974; and Massachusetts, $6,837.

The nonprofit organization Public Citizen produced a report in 2007 that ranked the Medicaid programs of all 50 states on eligibility, scope of services, quality of care and reimbursement. Massachusetts, Nebraska, Vermont, Alaska, Wisconsin were the top five, and Mississippi, Idaho, Texas, Oklahoma, South Dakota were the bottom five.