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I don't know the percentage so I don't know if it is a small fraction. The basic setup is:

Medicare - federal program for seniors

Medicaid - state program for poor people (there may be some sort of funding by the federal government, but it is run by the states)

Private insurance - this is paid by the individual and/or the company they work for

The laws/regulations regarding what is and isn't allowed with the private insurance is handled mostly by the states, not the federal government. The federal government has pushed for various rules (ACA/Obamacare) but there is a debate about the constitutionality of the federal government getting involved.

There are also specific programs within the governmental systems that focus on children (Insure Kids Now) and provide dental not just medical.

Within Medicare there are additional (supplemental) coverages that provides better benefits called Medigap.

I'm sure there are more programs than just Medicare and Medicaid, but those are the largest ones.



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