8 - intro_to_medicaid_medicare(1)

8 - intro_to_medicaid_medicare(1) - Medicare and Medicaid:...

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1 Medicare and Medicaid: A Very Brief Introduction ECO 381 December 6, 2011 (Some of these slides come from teaching materials of Prof. Bill Evans at Notre Dame University – used with his permission)
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2 Introduction Social insurance Government run insurance programs Typically have subsidized premiums have redistributive component Type of social insurance Poverty programs Old age (Social Security) Disability Health care/insurance Unemployment
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3 Definitions Entitlements Available to all who quality Example. If you quality for Medicaid (and enroll), you receive benefits In contrast, federally subsidized housing has a limited number of units, once units are gone, ‘benefit’ used up Mean tested Eligibility is determined by income/asset limits
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4 Federal government is the largest provider of health insurance in the country Medicare Medicaid Veterans’ Benefits Military Insurance In this section, we will discuss the first two Size of these programs make them important to consider
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5 Medicare – insurance for Elderly Disabled End stage renal disease Medicaid -- Insurance for Poor Low income elderly Blind/Disabled Long term care
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6 Insurance Medicaid provides insurance to around 40 million people each year Many are eligible for only a short time Enter and exit welfare Medicare about another 40 million
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7 Large fraction of Federal/State spending Large fraction of Health care spending Large Fraction of all people with insurance
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8 Basics of Medicaid Federally mandated program that is run by the states 51 different Medicaid programs Federal government determines Minimum eligibility requirements (e.g., TANF recipients are by definition eligible) Minimum benefit levels States determine Eligibility Scope of services Payments rates for services Administration of plan States can expand on federal mandates, they cannot restrict them
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9 Eligibility Two ways to become eligible Categorical eligibility If you are on particular federal income transfer programs, you are automatically eligible TANF (welfare) Supplemental Security Income (Disability insurance) Income/asset tests Used for special groups Children with low income Pregnant women with low income Elderly w/ high expenses or low income
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10 Financing of Medicaid Financed jointly by Feds and states Both paid for out of general revenues Reimbursement rates across states vary depending on per capita income of state
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11 SCHIP State Children’s Health Insurance Plan Designed to provide health insurance to children not poor enough for Medicaid but too poor to purchase health insurance States given autonomy to run program. Can use funds to Run independent program Use funds to expand Medicaid to include more kids
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12 Medicaid Managed Care and Traditional Enrollment, 1990-2004 
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This note was uploaded on 02/08/2012 for the course ECON 320 taught by Professor Chan during the Spring '11 term at SUNY Albany.

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8 - intro_to_medicaid_medicare(1) - Medicare and Medicaid:...

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