Medicaids Future

1
Medicaids Future

• Lynn Etheredge

2
Medicaid Coverage

• Medicaid is poorly designed to cover most of the
  uninsured
• 1980 Medicaid 26 B, uninsured 25 M
• 2005 Medicaid 330 B, uninsured 45 M
• Key problems
• Designed for charity care populations highly
  dependent on government programs, categorical
  ineligibility
• Inability to assist working populations...80 of
  uninsured
• Had Medicaid been re-designed, much of the
  uninsured problem might have been avoided

3
Medicaid Coverage

• Problems for working populations
• Categorical ineligibility, asset testing welfare
  office signup
• Lack of premium assistance options, inflexible
  benefits
• Medicaid provider networks plans
• State-to-state variations
• Compare tax credits national standards,
  income-based, worksite signup, flexible benefits,
  private insurance plans

4
Tax Credits Medicaid

• Tax credits Medicaid are the most promising
  framework for expanding coverage
• Most of uninsured are between Medicaid and
  tax-subsidized employer coverage
• National tax credits state (Medicaid)
  supplements, with national standards (phased-in)
• States will need long overdue Medicaid reforms to
  provide income-based eligibility, offer premium
  support, flexible benefits and private health
  plan options