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The Impact of the “Medigrant” Plan on the Federal Payments to States
The analysis examines the conference agreement plan for the redistribution of federal funds under a block grant for the Medicaid program. It also discusses the implications of the reductions in federal spending for beneficiary coverage.
This report analyzes trends in Medicare expenditures and considers options to modify the program to control its spending growth. It represents an effort to put in context the types of changes being discussed in the ongoing budget debate and to raise cautions, where appropriate, about various strategies.
The “New” Health Reform and Access to Care: The Problem in the Inner-City
This report examines issues regarding access to care for vulnerable populations. It presents a picture of urban America from 1970 to 1990 and raises strong concerns about the benefits of “new reform” strategies.
A side-by-side comparison of H.R. 2491, the Seven Year Balanced Budget Reconciliation Act of 1995, and S. 1357 Balanced Budget Reconciliation Act of 1995.
Public Attitudes Toward Welfare and Reform: A Focus Group Report
This focus group report provides further insight on some of the findings from a nationwide survey on welfare released by the Kaiser Family Foundation in March 1995 (#1045). This survey suggests that citizens are more concerned with the moral underpinnings of the current welfare system than with the amount of tax money used for the program, and found participant agreement on the importance of job training, education and child care programs.
Federal Dollars and State Flexibility: The Debate Over Medicaid’s Future
This journal article provides a basic overview of the Medicaid program and discusses the implications of a block grant to Medicaid and its beneficiaries.
This policy brief provides a summary of Medi-cal (California’s Medicaid program) and explores what impact Congressional Medicaid changes may have on California.
A National Household Survey of Health Inequalities in South Africa (2 volumes)
The first democratically elected government in South Africa has made improving health and health services for the historically underserved black majority a national priority. As part of this process, in June 1995, the Minister of Health, Dr. Nkosazana Dlamini Zuma, outlined a plan designed to provide free primary health care to all South Africans. This plan aims to improve the health status of South Africans, as well as the quality of care, through increased emphasis on disease prevention and early intervention. To establish a baseline from which to measure the impact of these improvements over time, the Henry J. Kaiser Family Foundation, in June 1994, commissioned this national household health survey, the first of its kind in South Africa. A nationally representative sample of 4,000 households was drawn and the data weighted to the universe of 7,594,000 households in South Africa and for the universe of each age category, taking into account the distribution of households within provinces, population groups and environment such as metro, urban or rural. The survey was coordinated by the Community Agency for Social Enquiry (CASE) and the questionnaire administered by Market Research Africa.
Neil Gilbert, Professor of Social Welfare, University of California at Berkeley, and Bernice Sandler, Senior Scholar in Residence, National Association for Women in Education, offer differing opinions as to the true extent of the problem of sexual assault in the United States. Gilbert charges that an overly broad definition of sexual assault has resulted in as exaggeration of the problem in this country; Sandler claims just the opposite is true. Both present compelling arguments as the basis for their viewpoints. Seminar participants reflect on the experts’ opinions and attempt to find common ground in this sensitive area. This publication was produced as part of an ongoing seminar series, jointly sponsored by the Kaiser Family Foundation and the American Enterprise Institute for PublicPolicy Research (AEI), on “Sexuality and American Social Policy.”
Medicaid and the Elderly
September 1995
Medicaid is a crucial health financing program for the elderly population, providing assistance to over 1 in 10 Americans age 65 or older. Nearly four million elderly people receive Medicaid assistance with medical and long-term care expenses. Medicaid’s coverage helps low-income elderly people gain access to health care services, eases financial burdens for medical expenses, and provides a safety net for long-term care coverage.
Medicaid plays three essential roles for elderly people. First, Medicaid makes Medicare affordable for low-income beneficiaries by paying the premiums, deductibles, and other cost-sharing requirements. Second, Medicaid provides coverage of medical benefits that Medicare does not cover, such as prescription drugs. Third, Medicaid stands alone as virtually the only public source of financial assistance for long-term care.
Initially designed to provide health benefits for welfare recipients, Medicaid’s role for vulnerable population groups has steadily expanded over the past three decades. Providing coverage for over 32 million Americans, Medicaid now serves as this nation’s primary health insurance program for low-income families and finances acute and long-term care for low-income elderly and disabled people. At a cost of $125 billion in 1993, Medicaid has become a major budgetary commitment for both the federal and state governments. Overall, the elderly account for 12 percent of Medicaid beneficiaries and 28 percent of program expenditures.
The Medicaid program is at a crucial point in its history as the Congress looks to Medicaid and Medicare to achieve significant reductions in federal spending. Over the next five years, federal Medicaid spending is projected by the Congressional Budget Office (CBO) to grow by between 10 and 11 percent per year. Concern over rising Medicaid costs, combined with efforts to reduce public spending, have fueled discussions of major restructuring of this program. The Budget Resolution agreed to by the House and Senate in June of this year calls for $182 billion in federal Medicaid savings from 1996 to 2002, about a 20 percent reduction in projected federal Medicaid spending. Proposals for reform have centered on transforming the program into a block grant that would establish strict limits on federal financial obligations and increase state flexibility in program design and operation. If enacted, these reforms would substantially alter the structure, operation, and financing of Medicaid with major implications for the elderly people Medicaid now serves.
Overview of Medicaid
Authorized under Title XIX of the Social Security Act in 1965 as companion legislation to Medicare, Medicaid is a means