As I rapidly begin to approach the ripe old age of becoming eligible for Medicaid and Medicare, like so many countless others, I begin to ponder if these programs will be there when they are truly needed? I mean, Medicaid, a sleeping giant of the United States health care program that neither Democrats nor Republicans desire touching, contains these five elements:

-costs shared between the federal government and state governments on a roughly sixty-forty split

-based on the number of beneficiaries, approximately sixty-eight million recipients in all, Medicaid is the single largest health insurance program

-debate focused mainly on private insurance subsidized through health exchanges, the program's expansion, and more liberal eligibility requirements, the Affordable Care Act has resulted in about eleven million more people gaining insurance coverage

-nearly three-fourths of Medicaid's participants are children and young adults. However, they only account for thirty-three percent of the costs associated with the program

-the disabled makes up the other quarter of Medicaid's recipients, but they also represent two-thirds of the program's costs. Quite a disproportion. Note that most of the expenses for the disabled are for long-term care, as well as nursing homes, that Medicaid does not cover

Over the course of the next thirteen years the Census Bureau projects that the percentage of Americans, eighty-five-years-old and older will rise to nine million people. Many of them will require nursing home care.

As The Donald's proposed budget for 2018 depicts, spending on the elderly for such programs as Medicaid, Medicare, and Social Security outweighs non-elderly spending. These leaves States to cover more of these expenses than they already are, which, no doubt, will eliminate available money for such things as parks, schools, police, roads, and lower taxes.

Medicaid's entitlement assures all who qualify for the program will receive its funds. This amounts to approximately one-fifth of the general revenues of most states according to Robin Rudowitz of the Henry J. Kaiser Family Foundation. According to their website, this Menio Park, California-based non-profit organization is highly recognized in the medical profession and provides the "most up-to-date and accurate information on health policy."

One possible alternative to these costs borne by the States is to transfer the costs of Medicaid's long-term care for the elderly to the federal government and merge Medicaid and Medicare together.

Another solution may be to allow the States to assume all of the costs of Medicaid for children and younger adults. One snag with this scenario is that States may have to surrender federal money received for schools, and trim other federal grants they receive, to do so.

These tactics would result in a swap meet of every federal dollar spent on elderly long-term care being matched by the States in lower spending on medical care for children and younger adults. For States, this spending would then become no longer tied to demographic changes.

As long as the federal trend remains bleeding the States for the costs of Medicaid, the expenses of the program will continue to be shouldered by the States instead of split into an even more viable option. Will Medicaid be there when it is really needed? What do you honestly believe?

I, myself, wonder?