<P> Loss of income and medical insurance coverage during the 2008--2009 recession resulted in a substantial increase in Medicaid enrollment in 2009 . Nine U.S. states showed an increase in enrollment of 15% or more, resulting in heavy pressure on state budgets . </P> <P> The Kaiser Family Foundation reported that for 2013, Medicaid recipients were 40% white, 21% black, 25% hispanic, and 14% other races . </P> <P> Unlike Medicaid, Medicare is a social insurance program funded at the federal level and focuses primarily on the older population . As stated in the CMS website, Medicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities, and (through the End Stage Renal Disease Program) people of all ages with end - stage renal disease . The Medicare Program provides a Medicare part A which covers hospital bills, Medicare Part B which covers medical insurance coverage, and Medicare Part D which covers prescription drugs . </P> <P> Medicaid is a program that is not solely funded at the federal level . States provide up to half of the funding for the Medicaid program . In some states, counties also contribute funds . Unlike the Medicare program, Medicaid is a means - tested, needs - based social welfare or social protection program rather than a social insurance program . Eligibility is determined largely by income . The main criterion for Medicaid eligibility is limited income and financial resources, a criterion which plays no role in determining Medicare coverage . Medicaid covers a wider range of health care services than Medicare . </P>

In what year did the us government enact both medicare and medicaid