assurance santé offers people the security that they can visit a doctor when they need to and that they won’t go bankrupt if they need medical care. It is a key part of the social safety net for millions of people in America and it is playing an increasingly important role as a result of health reform, including the availability of subsidized coverage through new health insurance marketplaces called exchanges and an individual mandate that will require most Americans to obtain health coverage or pay a penalty.

Until the 1960s, poor families mostly depended on charity care to get medical attention for themselves and their children. But when Medicaid was established, the quality of care for low-income families dramatically improved, triggering large drops in infant mortality and infectious diseases like influenza and pneumonia.

Today, Medicaid continues to expand access to healthcare, and is helping more than 97 million low-income Americans. It is also enabling states to provide a wider range of services, such as providing work incentives for people with disabilities and shifting home and community-based services for seniors and people with disabilities away from nursing homes. These initiatives have helped people stay healthier and more productive, reducing the need for costly emergency room visits and hospitalizations, and bringing health reform budget savings to states through lower payments to hospitals for uncompensated care.