Medicaid

This report is a collective summary of the impact and outcomes of Medicaid services to over half a million unique individuals with intellectual and developmental disabilities. Using data and statistics, from 2007, State rankings are given with the intention of providing guidance as to how each State performs overall in serving these individuals, acknowledging areas for each State that need improvement, and identifying top performance areas for each State, making resources easily identifiable.

Studies show that 70% of the uninsured children in the United States, approximately 5 million children, are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) yet remain uninsured, despite varying State outreach efforts. Beginning in 2008, Maryland introduced Maryland Kids First Act, a new and innovative way to identify and enroll eligible children; through income tax filings. Preliminary efforts, results, and challenges are outlined here.

Annual survey of all 50 States finds that during this time of recession the number of people on Medicaid is greatly increasing, as is the amount of money being spent on the program by individual States. Despite federal assistance from the American Recovery and Reinvestment Act (ARRA), this leads to further strain on already tight State budgets. This trend is expected to continue & States should be expecting a predicted increase of 6.3% on Medicaid spending in the 2010 fiscal year.

Spending on HCBS has grown in recent years, but little is known about what effect alternatives have on overall costs. An analysis of state data from 1995-2005 shows that for two population groups, spending growth was greater for states offering limited noninstitutional services than for states with large, well-established noninstitutional programs. Expansion of HCBS appears to entail a short-term increase in spending, followed by a reduction in institutional spending and long-term cost savings.

Guidance is offered for states in interpreting the sections of ARRA that impact Medicaid and CHIP. Program elements affected include tax credits, income used to calculate benefit levels, Federal Medical Assistance Percentage, Transitional Medical Assistance, protections for Native Americans, and transfers of assets. The attachment lays out program changes organized by ARRA section.

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.

Three researchers use data from the Survey of Income and Program Participation to estimate the expense of a mandatory personal assistance services (PAS) benefit under Medicaid for persons with low incomes, low assets, and significant disability. They conclude that the cost would be much lower than estimated by the Congressional Budget Office. They also argue that this step would help eliminate the institutional bias of Medicaid.

New York has 12 long-term care (LTC) programs: two residential and ten community-based. Data from all are compiled here with the goal of informing policymaking and addressing challenges to the state’s Medicaid LTC programs. An overview of current programs and a snapshot of data such as enrollment and spending are also presented. The first chapter takes a look at the whole system and four other chapters offer data on the largest programs in terms of people served and dollars spent.

The Chartbook documents trends in enrollment, earnings, employment, medical expenditures, and consumer experiences and satisfaction since Kansas began its Buy-In program. Summarized are survey and administrative data that document increased earnings and taxes paid over time by participants, decreased medical expenditures for those continuously enrolled, and improved quality of life and financial status.

Here is a snapshot of the program , seven years after implementation. The report introduces the grants, their assessment process, profiles funding recipients, and measures how well the program protects workers’ benefits and increases employment. Finally, recommendations for improving outcomes are provided.