Medicaid has been one of the most important programs in providing health care United States. The program is mainly eligible for families and individuals from low income families and resources. These include low income parents, children, old people, and disabled individuals (HHS.gov, 2009a). However, one does not qualify to the program for being poor extremely poor. The program covers more than 60% of those considered poor in United States. The program has been means-tested and is funded by both the federal and the states government, with management left to the states. Medicaid is a complex program with different features but this paper will review only two aspects of the program including Medicaid quality and initiatives and waiver and demonstration projects.