Medicaid: the role of the states

Article Abstract:

States are struggling with 30 new Medicaid mandates imposed by the federal government and with rising costs and growth in the program. The mandates, which relate to services, eligibility, and reimbursement, attempt to provide uniformity in the care of low-income people between states. States spend about 20% of their budgets on Medicaid and administer their own programs. The federal government sets eligibility to include people on welfare and others who meet restrictive low-income status. A large proportion of poor people is left out. Some states are trying to restructure Medicaid to improve access and to reduce costs. The District of Columbia and 44 states are enrolling Medicaid patients in managed care programs. A few states are allowing uninsured people to purchase Medicaid coverage. Budget restraints have affected reimbursement rates, which are about 47% of private insurance rates. The low fees discourage many physicians from accepting Medicaid patients.

Laws, regulations and rules, Medicaid

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The politics of Medicare

Article Abstract:

Medicare is a popular and efficient health care insurance program for the elderly that should be maintained. Medicare's payments to physicians have increased only 4% per year, despite a larger increase in fees. Medicare recipients appear to be more satisfied with their coverage than privately covered patients. Administrative costs are low: 97 cents go to direct care and only 3 cents to overhead costs. But Republicans want to use some of Medicare's funds to pay for tax cuts for the rich, and already have taken $87 billion from the Medicare Part A Trust Fund to pay for tax cuts to wealthy senior citizens. The Republicans have proposed a voucher system for Medicare. However, the proposal provides for an annual total Medicare expenditure rise of only 5.3%, which is too low to keep up with the growth in health care spending and with inflation.

Political aspects, Medicare

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