Disclaimer: Planned Parenthood believes in using gender-inclusive language. However, when we’re referencing government data and statistics, we have to use the data points they chose, which often don’t reflect the full range of gender identities. We hope that in the future, all research will better reflect and respect the diversity of gender.
It’s easy to mix up Medicaid and Medicare. They sound super similar and they’re both well-known government programs that help people get health care across the country. But it’s important to know the difference so you and the people you care about can benefit.
The Difference Between Medicaid and Medicare
Although Medicaid and Medicare are complex, here’s the main difference:
- Medicaid is insurance that aids people of all ages who have low incomes. Medicaid covers 21% of the U.S. population.
Medicare is insurance that primarily cares for people ages 65 years and up (with any income). Medicare covers 14% of the U.S. population.
Here’s where this gets tricky: Medicare also covers people of all ages who have disabilities or who are on dialysis — including people who need reproductive health care, such as birth control and pregnancy services. What’s more, people can be on both Medicaid and Medicare at the same time. (For these “dual eligible” beneficiaries, Medicare pays their claims first and Medicaid pays second.)
What Medicaid and Medicare Have in Common
Overall, Medicaid and Medicare provide health care for almost 108 million Americans. These federal programs also provide health care to a greater number of women than any other single source in America.
Together, their coverage includes several reproductive and sexual health care services — like wellness exams, STD tests and treatment, cancer screenings and treatment, prenatal and postnatal care, and labor and delivery.
Medicaid: America’s #1 Source for Reproductive Health Care
When you think of Medicaid, think of it as THE reproductive health care program in the United States. Here’s why:
- Women and girls are the majority of Medicaid’s 75 million enrollees.
- Medicaid covers more women’s health care than any other payer.
- Nationwide, Medicaid covers one in five (21%) of all women and girls of reproductive age. That’s 13.2 million people ages 15 to 44 years old.
- Medicaid covers nearly half of all births and 75% of family planning services.
Medicaid Serves People of Color
Due to racism and other systemic barriers that have contributed to income inequality, women of color disproportionately comprise the Medicaid population, or roughly 57% of women in the program overall. And they are also over-represented given their share of the general population. For example, 30% of African-American women and 24% of Hispanic women are enrolled in Medicaid, compared to only 14% of white women.
Why is that important to know? Because any limits on Medicaid hurt women of color in particular.
One example of a limit on Medicaid that hurts women of color: states refusing to adopt Medicaid expansion. As a result of the Affordable Care Act, adults who don’t have children and have incomes at or below 138% of the federal poverty level are entitled to Medicaid coverage if their states choose to expand Medicaid. To date, 37 states (including D.C.) have adopted the Medicaid expansion, and 14 states haven’t adopted the expansion. States that haven’t adopted Medicaid expansion lag behind in covering people with low incomes and vulnerable populations.
Medicare: Meeting Your Health Care Needs Later in Life
Similar to Medicaid, the majority (56%) of Medicare’s older enrollees are women. That’s 24 million women, ages 65 and up.
Medicare covers some of the same sexual and reproductive health services as Medicaid, but not all. Whereas Medicaid always covers birth control, only some Medicare plans do. That’s because Medicare focuses on the needs of older adults. To that end, Medicare covers special services for older women — like bone density screenings and medication for post-menopausal osteoporosis.
Because of the gender pay gap throughout their lives, older women are more likely to live in poverty and qualify for Medicaid than older men. Of the 50 million Medicare users age 65 and up, more than half (56%) are women. The gender disparity grows larger as people age: Two of every three Medicaid beneficiaries age 85 and up are women.
Who Pays for Medicaid & Medicare?
Medicaid is a jointly-run federal and state health insurance program. This means both state and federal tax dollars pay for Medicaid.
Medicare isn’t a joint federal-state program. Instead, Medicare is a federal insurance program. So, your federal tax dollars mostly pay for Medicare.
Do Planned Parenthood Health Centers Take Medicaid and Medicare?
Most Planned Parenthood health centers accept Medicaid, and some providers at Planned Parenthood health centers accept Medicare. Find a Planned Parenthood health center near you to learn what insurance plans they accept. You can also call 1-800-230-PLAN to speak with a Planned Parenthood staff member who can help you figure out coverage and costs.
Whether you have Medicaid, Medicare, any other insurance, or no insurance at all, you can always visit your local Planned Parenthood health center for the care you need, when you need it.
Can Medicaid and Medicare Cover Abortion?
No, in most cases, you can’t use Medicaid, Medicare, or any other federal health insurance program for abortion.
An unfair policy called the Hyde Amendment blocks federal funding for abortion with three narrow exceptions: when the pregnancy could kill the patient, or when the pregnancy results from rape or incest. Federal health programs cannot cover abortion even when a patient’s health is at risk and their health care provider recommends they get an abortion.
Still, 16 states with pro-reproductive health leaders have taken the bold step to cover safe, legal abortion with state funds for people who use Medicaid. That includes 15 states already covering it and Maine, whose coverage law will go into effect March 2020.
Failed Efforts to “Defund” Planned Parenthood Have Targeted Medicaid Beneficiaries
Anti-abortion politicians in the Trump-Pence administration, Congress, and certain statehouses across the country are trying to put safe, legal abortion out of reach. One of their key tactics is attempting to shut down Planned Parenthood through legislation they misleadingly named “defunding.” They made up that misnomer to confuse people about how funding works at Planned Parenthood.
“Defunding” policies block patients who use public health care programs — like Medicaid and Medicare — from accessing preventive health care at Planned Parenthood health centers. Preventive health care includes birth control, STD testing and treatment, and cancer screenings.
The politicians behind “defunding” don’t care that their policies make Planned Parenthood patients lose access to lifesaving preventive care. “Defunding” has one goal: to shut down Planned Parenthood and make safe, legal abortion harder to access (along with a lot of other sexual and reproductive health services).
Getting Political
The U.S. Department of Health and Human Services (HHS)’s Centers for Medicaid and Medicare Services (CMS) oversees the two programs. How you get your health care in the United States depends on what HHS prioritizes. And changes politicians make to Medicaid, Medicare and CHIP mean the difference between millions of people getting reproductive and sexual health care — or not.
Right now, CMS is overseen by Seema Verma, a former corporate health care consultant who thinks maternity coverage should be optional and made millions of dollars dismantling Medicaid in Indiana. Meanwhile, the Trump administration has forced Planned Parenthood out of the Title X program through a dangerous gag rule.
If you care about health care access in America, stay up-to-date on the politics behind Medicaid and Medicare. Visit PlannedParenthoodAction.org to learn more and get involved.
Open Enrollment
You may qualify for low-cost or free health insurance through Medicaid or the Children’s Health Insurance Program (CHIP), depending on your income and what state you live in. If you qualify for either program, you can enroll anytime without waiting for the enrollment period. To find out if you’re eligible for Medicaid or CHIP, visit your state’s Medicaid agency.
-Miriam at Planned Parenthood
