Medicaid covered populations

The U.S. is unique among advanced nations in that it has resisted the implementation of a system of imiversal health care and instead has gradually built a system in which employers are the primary sponsors of health care coverage for the majority of the population. Medicare and Medicaid cover the elderly, disabled, and very poor. According to data from the U.S. Census Bureau, a small proportion of people, less than 7% of the population under 65 years of age, purchase health insurance on their own. In 2002, the remaining 41 million persons were uninsured. The uninsured represent 14.6% of the total population, 16.5% of the population under 65 years. Those with adequate resources pay out of their pockets for health care. The others go without care, delay care, or seek health services from a fragile and incomplete system of charity care and safety-net providers. 

Primary care case management (PCCM) is a form of managed care used in Medicaid. It is most common in sparsely populated areas where there are no HMOs available to contract with the state. PCCMs are physicians or groups with arrangements with physicians that contract with the state Medicaid agency to coordinate and monitor the use of primary care services by enrolled beneficiaries. PCCM contracts cover less than the full set of Medicaid benefits and typically involve minimal financial risk. 

Private employers, the federal government, and state and local governments invest significant financial resources in health care purchasing expenditures. In 1995, private employers contributed 183.8 billion to private health insurance premiums, whereas the federal government spent 11.3 billion on private health insurance premiums, and state and local government spent 47.1 billion. " In 1995, more than 83% of the insured population was covered by private insurance, whereas about 31% was enrolled in a public program, such as Medicare or Medicaid. 

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