Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent residents, including low-income adults, their children, and people with certain disabilities. Poverty alone does not necessarily qualify someone for Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with limited income in the United States.

Beginning in the 1990s, many states received waivers from the federal government to create Medicaid managed care programs. Under managed care, Medicaid recipients are enrolled in a private health plan, which receives a fixed monthly premium from the state. The health plan is then responsible for providing for all or most of the recipient's healthcare needs. Today, all but a few states use managed care to provide coverage to a significant proportion of Medicaid enrollees. Nationwide, roughly 60% of enrollees are enrolled in managed care plans. Core eligibility groups of poor children and parents are most likely to be enrolled in managed care, while the aged and disabled eligibility groups more often remain in traditional "fee for service" Medicaid.

Randal Howard "Rand" Paul (born January 7, 1963) is the junior United States Senator for Kentucky. He is a member of the Republican Party. A member of the Tea Party movement, he describes himself as a "constitutional conservative" and a libertarian. He is the son of Republican Congressman and 2012 Republican presidential candidate Ron Paul of Texas and had never previously held political office. Paul first received national attention in 2008 when making political speeches on behalf of his father. Rand Paul is the first United States Senator in history to serve alongside a parent in the United States House of Representatives.

A graduate of the Duke University School of Medicine, Paul has been a practicing ophthalmologist in Bowling Green, Kentucky, since 1993, and established his own clinic in December 2007. In 1994, he founded Kentucky Taxpayers United, of which he is still the chairman.

In 2010, Paul ran as the Republican candidate for the United States Senate seat being vacated by retiring Senator Jim Bunning of Kentucky and defeated Kentucky Attorney General Jack Conway. As a supporter of the Tea Party movement, Paul has been vocal in advocating for term limits, a balanced budget amendment, and the Read the Bills Act, in addition to the widespread reduction of federal spending and taxation. He has gained prominence for his independent positions on many political issues, often clashing with both Republicans and Democrats.