Medicaid was enacted in 1965 to provide health care to the aged and the poor. Today, it plays a key role in the nation's health care system, covering more than 50 million Americans and about 250,000 Utahns.

How is it funded?

The federal government matches state spending. Utah's match is 3-to-1 and higher for some programs. Utah plans to spend $252.4 million in fiscal 2005, plus a federal match of $1.19 billion.

Who is covered?

Eligibility is tied to federal poverty guidelines. The federal government mandates some coverage - such as young children in families that earn less than 133 percent of the guidelines, or $25,735 for a family of four. But each state has developed its own version of Medicaid, deciding what additional groups to cover and which medical services to include.

How does it work?

Generally, out-of-pocket costs are low. Recipients pay no annual premium and co-payments range from none for preventive care to $2 to $3 for office visits. There are no coverage ceilings. Some recipients must spend a portion of their incomes on medical bills to become eligible.

How does it work with

Medicare?

Some low-income seniors are eligible for both programs. Medicaid can help pay Medicare expenses, such as premiums, or extend benefits, such as prescription drug coverage.

What is the problem?

As the economy has dipped, enrollment has increased. Medicaid has grown to cost $300 billion a year, an amount federal and state officials say is not sustainable.

Sources: Associated Press, Utah Department of Health, Centers for Medicare and Medicaid Services.