For a number of years, Governors and other state policymakers have maintained that Medicare - rather than state Medicaid programs - should play the key role in providing prescription drug coverage to Medicare beneficiaries, including those who also qualify for Medicaid because they are impoverished and/or have extensive health care needs (i.e, the "dual eligibles").

As the U.S. Congress continues to search for an agreement on the form of a Medicare prescription drug benefit, the Commission has two new reports related to the debate.

This issue paper provides state-level estimates on spending on dual eligibles and illustrates the fiscal effects of scenarios where the federal government assumes the cost of prescription drugs, Medicare premiums, acute care, and long-term care for this population. Issue Paper (.