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This paper explores the role of MaineCare, Maine’s Medicaid program, in the state’s health care system and the relationship between MaineCare and the Dirigo Health plan that the state approved in 2003. Report (.pdf)
New Directions for Medicaid Section 1115 Waivers: Policy Implications of Recent Waiver Activity Seventeen states have had comprehensive Section 1115 waivers approved since January 2001. This brief provides an overview of this recent waiver activity and reviews the implications for coverage and access to care. Policy Brief (.pdf)
One State’s Medicaid Managed Care Formulary Operations: A Look at Pennsylvania, 2001-2002 This report examines formulary implementation under mandatory Medicaid managed care in Pennsylvania between 2001 and 2002. It looks at one state during a yearlong period; formulary operations are likely to vary across states and programs and over time. The report includes findings about Pennsylvania’s formulary operation and observations about improving the system. Report (.pdf)
Health Coverage for Low-Income Adults: Eligibility and Enrollment in Medicaid and State Programs, 2002 This policy brief provides new information on the number and characteristics of nonelderly adults eligible for Medicaid and other public coverage and on their enrollment. Because low-income adults often work at jobs that do not offer employer-sponsored coverage and individual coverage is prohibitively expensive for them, their uninsured rates are high. Although Medicaid and the State Children's Health Insurance Program (SCHIP)…
Overview and Briefing Charts This chartpack reviews the President’s FY 2006 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by an overview of federal surplus/deficit spending patterns dating back to 1969. It then turns to summary information on the overall composition of the Administration’s budget, followed by the President’s proposed funding for some of the major programs…
Medicaid Financing Issues: Intergovernmental Transfers and Fiscal Integrity Since its enactment in 1965, Medicaid has been a joint venture between the states and the federal government. While each state administers its own Medicaid program within broad federal guidelines, the federal government provides over half of the program’s financing. As a result, Medicaid represents a spending item, but it is also the single largest source of federal revenue to the states. In recent years there has…
Dual Eligibles: Medicaid's Role for Low-Income Medicare Beneficiaries This fact sheet and set of tables describe the over 7 million “dual eligibles,” the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. The fact sheet describes why this population needs Medicaid, what services they receive from Medicaid, and the current policy challenges related to dual eligibles, including the new Medicare prescription drug benefit. The set of tables, prepared by the…
Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005
Medicaid's Optional Populations: Coverage and Benefits Medicaid reform discussions have often focused around giving states greater flexibility over optional populations and services. This issue brief presents an overview of Medicaid's optional beneficiaries and services and provides examples of who qualifies as "optional" and the services they use. Issue Brief (.pdf)
Financing Health Coverage: The State Children's Health Insurance Program Experience Enactment of SCHIP sought a balance between increasing funds available for coverage and limiting total federal outlays. While SCHIP has had widespread support and success in helping to provide coverage for uninsured children, its capped financing system has also created challenges for states, including inequities among states and projected federal funding shortfalls. This issue brief explores three basic sets of issues associated with SCHIP’s…
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