Medicaid, created at the same time as the Medicare program, is a welfare program that provides medical benefits and long-term care assistance to certain groups. The program is funded jointly by the states and the federal government, but each state administers the program independently, consistent with federal guidelines. The program is voluntary; however, every state has participated since 1982. Each state determines eligibility requirements, but, in general, poor children, pregnant women, the blind, disabled, and impoverished elderly are the groups most likely to receive Medicaid assistance. Medicaid provides both medical assistance and long-term care coverage for those who qualify. In 2001, >46 million Americans received Medicaid coverage, at a cost of $278 billion in 2003.