This brief reviews Medicaid’s current eligibility structure and the health needs of the people covered by Medicaid. Due to the trends of limited and declining access to private health coverage in the low-income population and the growing health and long-term care demands of an aging population, a broader model for Medicaid eligibility is considered and the implications of recent legislative and policy developments for coverage are assessed.

Issue Brief (.pdf)

Toplines: Seniors’ Early Experiences with the Medicare Prescription Drug Benefit

These toplines contain the detailed results from the April 2006 tracking poll on seniors’ early experiences with the new Medicare drug benefit.

Toplines (.pdf)

The Medicare Modernization Act established a voluntary prescription drug benefit for Medicare’s elderly and disabled beneficiaries provided by private plans that is open to all beneficiaries.

This paper focuses on the decision-making process and the factors that influence decisions about Medicare drug plans, as well as beneficiaries’ early experiences and future concerns related to their prescription drug coverage. It is based on in-depth interviews held in March 2006 with diverse beneficiaries in four cities: Baltimore; Lincoln, Neb.; Miami; and Sacramento, Calif.

Report (.pdf)

Chartpack: Seniors’ Early Experiences with the Medicare Prescription Drug Benefit

These charts highlight key data from the April 2006 tracking poll on seniors’ early experiences with the new Medicare drug benefit.

Chartpack (.pdf)

Immigrants in the U.S. face increasing challenges securing health care coverage. They have less access to employer-sponsored insurance than native citizens and face tighter restrictions on their eligibility for Medicaid and SCHIP, the nation’s major public health coverage programs for low-income children and families.

This fact sheet provides an overview of the current rules on immigrants’ eligibility for Medicaid and the State Children’s Health Insurance Program.

Fact Sheet (.pdf)

Beyond Cash and Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs

This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver.

Issue Brief (.pdf)

Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance

Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act (DRA) of 2005 tightened Medicaid eligibility rules related to asset transfers. About 43 percent of all nursing home residents eventually become Medicaid eligible.

This brief concludes that for people becoming Medicaid eligible at the time of nursing home admission, 50 percent had asset (cash and deed) transfers of less than $5,000. Conversely, only 13 percent of people who became Medicaid eligible at admission transferred more than $50,000. Asset transfer patterns were most common among nursing home residents who did not receive Medicaid assistance, with over 50 percent of the group making a transfer. Over the six-year period examined, the authors estimate that, when applying the DRA asset transfer rules, federal savings to Medicaid could amount to $1.87 billion.

Issue Brief (.pdf)

This brief presents new information on the distribution of Medicaid spending for all enrollees, including those residing in institutions. The analysis finds that fewer than five percent of enrollees (each exceeding $25,000 in annual costs) account for almost half of all Medicaid spending.

Issue Brief (.pdf)

Home Transition Programs: Perspectives of Medicaid Care Planners

This report draws on interviews with Medicaid care planners for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

Report (.pdf)

Nursing Home Transition Programs: Perspectives of State Medicaid Officials

This report draws on interviews with state Medicaid program officials for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

Report (.pdf)