Analysis of the Maryland Medicaid Program in Relation to Sustainable Development Goals

Program Overview and Scope

The Maryland Medicaid program, locally referred to as Medical Assistance, functions as a critical public health insurance initiative. It is the largest healthcare program in the United States, providing free or low-cost health coverage to approximately 1.5 million residents, which constitutes nearly one-quarter of Maryland’s population.

• Covered Population: Eligibility extends to low-income adults, children, pregnant women, elderly adults, and individuals with disabilities.
• Demographic Impact: Children represent half of all beneficiaries, highlighting the program’s significant role in pediatric health.

Contribution to SDG 3: Good Health and Well-being

The program is a primary driver for achieving the objectives of SDG 3 by ensuring healthy lives and promoting well-being for all ages within the state.

1. Universal Health Coverage (Target 3.8): By providing accessible and affordable health insurance, Medicaid directly advances the goal of universal health coverage, ensuring vulnerable populations can obtain essential health services without suffering financial hardship.
2. Maternal and Child Health (Targets 3.1 & 3.2): The specific inclusion of pregnant women and the extensive coverage of children directly support the reduction of maternal mortality and promote healthy outcomes for newborns and children.
3. Access for Vulnerable Groups: The program guarantees access to healthcare for the elderly and persons with disabilities, key populations often facing barriers to care.

Impact on Broader Socioeconomic SDGs

Beyond health, the Maryland Medicaid program contributes significantly to other interconnected Sustainable Development Goals.

• SDG 1 (No Poverty): The provision of free or low-cost health insurance alleviates the financial burden of medical expenses on low-income families, a critical factor in preventing descents into poverty.
• SDG 10 (Reduced Inequalities): Medicaid is a fundamental tool for reducing health-related inequalities. It ensures that access to quality healthcare is not determined by income, age, or disability status, thereby promoting social and economic inclusion.
• SDG 5 (Gender Equality): By ensuring healthcare access for pregnant women, the program addresses specific female health needs and supports maternal well-being, which is a cornerstone of gender equality.

Analysis of the Article in Relation to Sustainable Development Goals

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The article’s primary focus is on Medicaid, a “public health insurance program” designed to ensure access to healthcare. This directly aligns with the goal of ensuring healthy lives and promoting well-being for all at all ages.
2. SDG 1: No Poverty
   • The article specifies that Medicaid is for “eligible low-income adults.” By providing “free or low-cost health insurance,” the program acts as a social safety net that protects individuals and families from the catastrophic health expenditures that can lead to or exacerbate poverty.
3. SDG 10: Reduced Inequalities
   • Medicaid targets specific vulnerable populations, including “low-income adults, children, pregnant women, elderly adults, and people with disabilities.” By ensuring these groups have access to healthcare, the program works to reduce health and economic inequalities within society.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services…
   • The article describes Medicaid as the “largest health care program in the United States,” which provides “free or low-cost health insurance” to 1.5 million people in Maryland. This is a direct effort to expand health coverage and provide financial risk protection, which are central components of Target 3.8.
2. Target 1.3: Implement nationally appropriate social protection systems and measures for all… and achieve substantial coverage of the poor and the vulnerable.
   • Medicaid is presented as a government-run “public health insurance program,” which qualifies as a social protection system. The article highlights its substantial coverage of the vulnerable by stating it covers “nearly one in four Marylanders,” specifically targeting “low-income” individuals.
3. Target 10.2: By 2030, empower and promote the social… inclusion of all, irrespective of age… disability… or economic or other status.
   • The program’s eligibility criteria, which include “children, pregnant women, elderly adults, and people with disabilities,” demonstrate a clear policy to ensure social inclusion for these groups by removing barriers to essential healthcare services.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicator 1.3.1: Proportion of population covered by social protection floors/systems… distinguishing children… older persons, persons with disabilities, pregnant women… and the poor and the vulnerable.
   • The article provides specific data points that serve as direct measures for this indicator:
     • The total number of people covered: “about 1.5 million people.”
     • The proportion of the state population covered: “Nearly one in four Marylanders.”
     • The proportion of children covered: “Half of those covered are children.”
     • It also explicitly mentions the other target groups (pregnant women, elderly, people with disabilities, low-income adults), implying that data on their coverage exists.
2. Indicator 3.8.1: Coverage of essential health services (defined as the average coverage of essential services…).
   • While the article doesn’t detail the specific services covered, the fact that 1.5 million people are enrolled in a “health insurance program” is a primary measure of service coverage. The number of beneficiaries is a direct proxy for the reach of health coverage.
3. Indicator 3.8.2: Proportion of population with large household expenditures on health as a share of total household expenditure or income.
   • The article implies progress on this indicator by describing the program as “free or low-cost.” This feature is designed to reduce or eliminate large out-of-pocket health expenditures for enrolled low-income populations, thereby protecting them from financial hardship due to medical costs.

4. Summary Table of SDGs, Targets, and Indicators

Source: health.maryland.gov