Medicaid and the limits of state health reform sparer michael published by temple university press sparer michael medicaid and the limits of state health reform. Health reform this category includes information on state health insurance marketplaces medicaid and health reform medicare and health reform federal grants and loans health insurance market reforms and other relevant indicators. With the defeat of national health reform many liberals have looked to the states as the source of health policy innovation at the same time many in the new republican majority and several governors also support increased state control. Medicaid and the limits of state health reform book description at the same time many in the new republican majority and several governors also support increased state control. Created in 1965 medicaid is a public insurance program that provides health coverage to low income families and individuals including children parents pregnant women seniors and people with disabilities it is funded jointly by the federal government and the states