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Medicaid Financing

Compiled by Arden Rice, December 2005

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In April 2005, Congress passed a budget resolution to reduce federal Medicaid funding by $10 billion over the next five years. At the same time, Medicaid costs are rising because of increased spending on prescription drugs, the demand for long-term care, and the increasing numbers of people who lack health insurance. As a result, Medicaid is becoming one of the largest portions of a state’s budget. Several groups, including the U.S. Medicaid Commission, the National Governors’ Association, and the National Conference of State Legislatures have recently released recommendations for reforming Medicaid.

Federal and State Outlook on Health Care / a special supplement to CQ Weekly Governing, June 2005. (614.01/C761a) Features articles on reform efforts and an interview with the head of the federal agency overseeing Medicaid.

Making Medicaid Work for the 21st Century / National Academy for State Health Policy, 2005. (369.33/N213) www.healthpolicywatch.org/research.asp?pubid=698

Managing Medicaid Costs: A Legislator’s Tool Kit / National Conference of State Legislatures, 2001. (369.33/N21r) Summarizes issues and trends in funding and discusses the pros and cons of 10 options for cutting costs.  www.ncsl.org/programs/health/forum/cost/containment.htm

Medicaid and Budget Reconciliation: Options and Implications of Savings Proposals / Kaiser Commission on Medicaid and the Uninsured, October 2005. (369.33/K12i) www.kff.org/medicaid/upload/Medicaid−and−Budget−Reconciliation−Options−and−Implications−of−Savings−Proposals.pdf

“Medicaid Comes of Age” / Health Affairs, January/February 2003. (614.23/P94/2003/v.22/no. 1) Contains a dozen articles on public health issues and fiscal policy related to Medicaid.

Medicaid Prevention and Public Health: Invest Today for a Healthier Tomorrow / American Public Health Association, 2005. (369.33/Am311) www.apha.org/medicaidwhitepaper/medicaidwhitepaper_full.pdf 

Medicaid: A Snapshot for State Legislatures / National Conference of State Legislatures, 2004. (369.33/N21s) www.ncsl.org/programs/health/medicaidsnapshot.htm

Medicaid: States’ Efforts to Maximize Federal Reimbursements Highlight Need for Improved Federal Oversight / U.S. Government Accountability Office, 2005.   (GAO05836T). (369.33/X6/pt. 2) States are reimbursed at different rates for Medicaid services depending on whether the services are for health care or Medicaid administration. Some states have shifted costs to be eligible for more federal funds through higher reimbursement rates. www.gao.gov/docsearch/abstract.php?rptno=GAO−05−836T

“Medicaid: 10 Fixes that Work”/ State Legislatures, March 2004. (328.11/N214/2004/v. 30/no. 3)

Medicaid: Transfers of Assets by Elderly Individuals to Obtain Long-Term Care Coverage / U.S. Government Accountability Office, 2005. (GAO05968). (369.33/X6/pt. 1) Some reform advocates recommend extending the “look-back” period for reviewing the transfer of financial assets of potential Medicaid recipients from three to five years to compel people to pay more of their own health care costs. www.gao.gov/docsearch/abstract.php?rptno=GAO−05−968

Medicaid: Who Benefits, How Expensive Is It, and What Are States Doing to Control Costs? / Center for Excellence in Family Studies, UW-Madison, 2005. (Wisconsin Family Impact Seminars briefing report). (369.33/W7q)

Medical Assistance, BadgerCare, SeniorCare and Related Programs / Wisconsin Legislative Fiscal Bureau, 2005. (Informational paper no. 43). (369.33/W7p/2005) Provides an overview of Medicaid and Medicaid waiver programs in Wisconsin. www.legis.wisconsin.gov/lfb/Informationalpapers/43.pdf

[Medical Assistance (MA) Daily Cost of Nursing Home Care] / Wisconsin Department of Health and Family Services, 2004/2005. (HFS/m) (noncirculating) Report mandated by Wis. Stats. S. 49.45(6m)L.

Report to the Legislature, Community Options Program, Community Options Program Waiver for Calendar Year 2003 / Wisconsin Bureau of Aging and Long Term Care Resources, 2005. (614.08/W7p/2003) This annual report describes the extent of home based care offered to the elderly and disabled through Wisconsin’s Medicaid waiver programs. http://dhfs.wisconsin.gov/ltc_cop/2003FinalLegReport.pdf

Short-Run Medicaid Reform / National Governors’ Association, August 29, 2005. (369.33/N214) www.nga.org/Files/pdf/0508MEDICAIDREFORM.PDF

The State Factor: Abolishing the Medicaid Ghetto − Putting ‘Patients First’ / American Legislative Exchange Council, 2002. (369.33/Am3a) www.alec.org/meSWFiles/pdf/0206.pdf

State Policy Reports / Federal Funds Information for States, 2004-2005.
(328/St1)
Succinct explanations of how the federal government reimburses the states for Medicaid and how fluctuations in the reimbursement rates, state budgets, and the economy impact Medicaid funding. (Additional articles available in earlier issues as well.)

  • Is Medicaid’s Day of Reckoning Near? / v. 23, no. 9, 2005.
  • Medicaid Rematch / v. 22, no. 10, 2004.
  • Medicaid’s One-Two (Three-Four?) Punch / v. 23, no. 4, 2005.
  • Take That! And That! / v. 22, no. 7, 2004.

Wisconsin Medicaid Program / Wisconsin Department of Health and Family Services, 2005. (369.33/W7i9) http://dhfs.wisconsin.gov/medicaid4/ma_overview/medicaid_overview.pdf 

Related Web Sites:

www.cbo.gov/showdoc.cfm?index=6316&sequence=0 − The Cost and Financing of Long Term Care Services: Congressional Budget Office Testimony Before the Subcommittee on Health, Committee on Energy and Commerce, U.S. House of Representatives.

http://content.healthaffairs.org/cgi/collection/medicaidHealth Affairs online archive of articles on Medicaid.

www.cbpp.org/pubs/health.htm − Health Policy Analysis from the Center on Budget and Policy Priorities.

www.familiesusa.org/issues/medicaid/medicaid−action/ − Medicaid Action Center from Families USA.

http://kff.org/medicaid/benefits/index.jsp − Medicaid Benefits: Online Database maintained by the Kaiser Family Foundation. Produces 50 state surveys of benefits and charges for dozens of health services or allows one to display a summary of data for all categories of services for an individual state.

www.gao.gov/docsearch/abstract.php?rptno=GAO−05−748 − “Medicaid Financing: States’ Use of Contingency-Fee Consultants to Maximize Federal Reimbursements Highlights Need for Improved Federal Oversight”, U.S. Government Accountability Office, 2005. (GAO−05−748).

www.gao.gov/docdblite/details.php?rptno=GAO−03−620 − “Medicaid Formula: Differences in Funding Ability Among States Often Are Widened”, General Accounting Office, 2003. (GAO−03−620). This report identifies flaws in the federal formula for Medicaid reimbursement which is intended to narrow the gap among states in their ability to fund Medicaid programs.

www.healthtransformation.net/projects/Medicaid__Transformation/ − Medicaid Transformation Project from the Center for Health Transformation.

http://kff.org/medicaid/spending.cfm − Medicaid/SCHIP spending and budgets from the Kaiser Family Foundation. Over 75 articles and reports offering statistics and analysis.

www.nasmd.org/ − National Association of State Medicaid Directors.

www.ncsl.org/programs/health/h−medicaid.htm − National Conference of State Legislatures Medicaid site.

www.ncsl.org/statefed/health/MArefPrinc.htm − National Conference of State Legislatures Principles for Medicaid Reform.

www.cbo.gov/showdoc.cfm?index=6564&sequence=0 − Payments for Prescription Drugs under Medicaid: U.S. Congressional Budget Office Testimony before the Special Committee on Aging, United States Senate Committee.

www.cms.hhs.gov/medicaid/waivers/waivermap.asp − State Waiver Programs and Demonstrations.

www.nhpf.org/M%26M%5FE%2Ebrief%2Ebook%2Fcontents%2Ehtm − Understanding Medicare and Medicaid: Fundamentals and Issues for the New Congress: an Electronic Briefing Book from the National Health Policy Forum.

www.cms.hhs.gov/faca/mc/details.asp − U.S. Department of Health and Human Services Medicaid Commission. Submitted recommendations to Congress on September 1, 2005, for ways to reduce Medicaid costs by over $11 billion in the next five years.

www.wha.org/governmentRelations/medicaid.aspx − Wisconsin Hospital Association − Medicaid.

www.legis.wisconsin.gov/assembly/asm23/news/HEARING2005.04.05.htm − Wisconsin Legislature, Assembly Committee on Medicaid Reform.

Clippings:

(Noncirculating; available for use in the library; clippings prior to 1981 are on microfiche)

  • Medical assistance − Old age: 369.32/Z
  • Medical assistance − Poor: 369.33/W7z (Wisconsin); 369.33/Z (U.S.)

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