Kaiser Family Foundation

Achieving comprehensive health reform has emerged as a leading priority. In Congress, a number of comprehensive reform proposals have been announced as the debate proceeds. This interactive side-by-side compares the leading comprehensive reform proposals across a number of key characteristics and plan components. Users can choose one or more proposals and one or more topics for comparison.

The brief explains how Medicaid works in today’s health care system and answers some of the key questions of how Medicaid fits into broader health reform efforts. Information is given in question and answers. The authors offer their opinion on how eligibility, benefits, finance, and other characteristics of the program should be changed.

Medicaid currently fills in the gaps in Medicare’s benefit package for 8.8 million enrollees with limited income and resources (dual eligibles). Shifting aspects of this financing to the Federal government could save states money and create opportunities for better care management and coordination. Data tables show how much each state could save if certain financing roles were shifted.

For many years, Section 1115 waivers have been used in the Medicaid program and the Children’s Health Insurance Program, to provide states an avenue to test and implement coverage approaches that do not meet federal program rules. While these waivers have facilitated important program evolutions over time, some have also raised issues. This brief reviews the experience of Section 1115 Medicaid and CHIP waivers and discusses issues for the Obama administration to consider for the future.

Medicaid covers health and long-term care services for many millions of low-income Americans. Conversations were already underway at this event concerning the role of Medicaid as a vehicle for economic stimulus, and about health coverage expansion proposals, with particular discussion around the challenges facing states implementing the program in the recent economic downturn.

This fact sheet examines the assistance for Medicaid programs and key health provisions in the ARRA that President Obama signed into law on February 17, 2009. Subjects covered include the temporary increase in federal matching money for state Medicaid programs, subsidies for COBRA health coverage for laid off workers and funding for health information technology. It includes a breakdown of additional federal allocations to states for Medicaid costs under the act.

An interactive map displays how many 1915(c) waivers each state has. Clicking on a state’s name displays number of participant and expenditures by waiver type as compared to nationwide numbers. Participant and expenditure data are also available for personal care, home health, and individualized budget services. Clicking “Compare” in any data area displays a table illustrating selected data for all states. Information is taken from CMS form 372 and is downloadable.

PAS Center offers state-by-state participant and expenditure data for all of Medicaid and the three main HCBS programs: 1915(c) waivers, home health, and state plan personal care. The December 2008 update provides 2005 data complemented by survey results related to program policies and provider reimbursement rates.

Recessions deliver a one-two punch to Medicaid by undercutting available public funds and increasing demand for services. This policy brief presents several options for strengthening Medicaid during these periods. Options outlined include: directing federal funding support; quickly reauthorizing SCHIP; simplifying enrollment; easing burdens imposed by the process of proving citizenship; and expanding coverage to those hit hardest by recession.

Everything from program structure, eligibility, services, financing and expenditures are covered here in concise summaries. This updated edition also contains graphics showing expenditures by service and the growth of Medicaid acute care spending as compared to private health plans. The tables at the end present data broken down by state. Refer to the 2007 version for historic perspective.