Medicaid: Restructuring Approaches Leave Many Questions

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Report Type	Reports and Testimonies
Report Date	April 4, 1995
Report No.	HEHS-95-103
Subject	Block grants Federal/state relations Financial analysis Financial management Health care cost control Health services administration Income maintenance programs Intergovernmental fiscal relations Medicaid State-administered programs Welfare benefits Supplemental security income AFDC Aid to Families with Dependent Children Program Food Stamp Program Job Opportunities and Basic Skills Training Program JOBS Program Special Supplemental Food Program for Women, Infants, and Children

Summary:

Over the years, various proposals have been made to restructure the Medicaid program. One approach calls for providing federal block grants to the states and giving them increased responsibility for running the program. Under another proposal, Medicaid would be entirely funded and administered by the federal government. Yet another would split Medicaid into two programs, one encompassing acute and primary care and the other long-term care. This report compares the different restructuring and approached and discusses their implications for federal-state financing and administration of the program. GAO also provides information on the need to establish a federal "rainy day" fund if restrictions, such as block grants, were placed on federal revenues paid to states. GAO also provides the most recent data on the amount of federal Medicaid funds provided to each state.

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Medicaid: Restructuring Approaches Leave Many Questions