What areas of government are involved?

With the sweeping reforms in the Obama Administration, there would be federal standards for all of America's health care. Currently, medicaid programs are funded by the federal and state governments. However, the recession has caused state budgets to be cut, reducing the funding for the program overall. The Department of Health and Human Services has a whole website showing the plans the hope to achieve. The current system of Medicaid is run at the state level. Here's the link to Virginia's Medicaid page.