Medicaid is a means-tested program providing health care for the poor. Government-funded health care accounts for 22 percent of the federal budget. Medicaid is the second-largest line item in most state budgets, representing 25 percent of the total state spending. Although jointly funded by federal and state governments, Medicaid is administered at the state level. Eligibility, services, and provider reimbursement rates vary widely by state. Medical providers are paid less to treat Medicaid recipients than patients with either Medicare or private insurance. Medicaid pays 72 percent of Medicare rates for most services but only 66 percent for primary care. Given the poor reimbursement, few primary care providers (PCPs) accept Medicaid patients. The Affordable Care Act (ACA) is increasing primary care reimbursement to match Medicare’s rates, ...