A brief history of Medicaid and America’s long struggle to establish a health care safety net

The Medicaid system^[1] has emerged as an early target of the Trump administration’s campaign to slash federal spending. A joint federal and state program, Medicaid provides health insurance coverage for more than 72 million people^[2], including low-income Americans and their children and people with disabilities. It also helps foot the bill for long-term care for older people.

In late February 2025, House Republicans advanced a...

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