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Medicaid: Three States' Experiences in Buying Employer-Based Health Insurance

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Report Type Reports and Testimonies
Report Date July 25, 1997
Report No. HEHS-97-159
Subject
Summary:

The states are required to pay the premiums, deductibles, and coinsurance for Medicaid-eligible persons with access to employer-based health insurance if doing so saves money for Medicaid. GAO reviewed efforts by three states--Iowa, Pennsylvania, and Texas--to meet this requirement and found that enrollment and cost savings have so far been relatively small. This report discusses (1) the extent to which selected states are purchasing employer-based health insurance for Medicaid-eligible persons and achieving budgetary savings, as well as the potential for greater savings; (2) the cost-effectiveness criteria these states use and the populations and services covered; (3) the outreach efforts used and barriers hindering states' implementation of section 1906, which Congress added to the Social Security Act; and (4) legislation proposed to improve states' efforts.

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