Differences Between Medicare and Medicaid Medicare is a federal program primarily for individuals aged 65 and older or those with certain disabilities, regardless of income. It is funded through payroll taxes, premiums, and general revenues. Medicaid, on the other hand, is a means-tested program jointly funded and administered by federal and state governments to serve low-income individuals and families. Unlike Medicare, Medicaid covers long-term care and offers more comprehensive benefits, particularly for low-income children and pregnant women. Importance of Financial Considerations in Policy Financial constraints play a central role in shaping health policy. Policymakers must balance cost containment with expanding access and maintaining quality. Programs like Medicaid expansion face political resistance due to long-term budgetary impacts. For example, some states chose not to expand Medicaid under the ACA because of concerns about future costs and federal matching funds sustainability (Gruber, 2011)