This study estimates the effect of Medicare Advantage (MA) payments and State Medicaid policies on the choice by Medicaid eligible Medicare beneficiaries to either join a MA plan, remain in the fee-for-service (FFS) and enroll in Medicaid (dually enrolled), or remain in FFS Medicare without joining Medicaid. Individual plan choice was modeled using a multinomial logit. The sample includes Medic...

Steep declines in the uninsured population under the Affordable Care Act (ACA) will depend on high enrollment among newly Medicaid-eligible adults. We use the 2009 American Community Survey to model pre-ACA eligibility for comprehensive Medicaid coverage among nonelderly adults. We identify 4.5 million eligible but uninsured adults. We find a Medicaid participation rate of 67% for adults; the r...

Presented in this article is an overview of Medicaid policies affecting persons in nursing homes and other institutions that provide long-term care--the criteria they must meet to qualify for Medicaid and the costs of care paid by the Medicaid program and by Medicaid recipients themselves. Underlying these complex policies, and creating sometimes peculiar consequences, is the fact that the popu...

Although the rapid increase in Medicaid managed care during the early 1990s attracted commercial plans to the program, by the late 1990s commercial plan participation in Medicaid had begun to decline. This study examines the role of Medicaid policies, plan characteristics, and local health care market conditions in a commercial plan's decision to exit. We find that many of the factors that infl...

States have increasingly used Health Maintenance Organizations (HMOs) to provide medical services to the Medicaid population. However, the effects of these initiatives on total health-care expenses, the mix of utilization, and access to care remain unclear. We examine the effect of changes in Medicaid HMO penetration between 1996 and 2002 on these outcomes using data for the nonelderly Medicaid...

In the thirty-seven years since its creation, Medicaid has grown in terms of whom it covers and what it costs. Current rates of Medicaid enrollment and cost growth are high relative to state budget capacity, but not by historical standards. The current Medicaid fiscal crisis is a result of weak state fiscal conditions and the gradual accretion of populations and services covered by Medicaid. St...

As long-term care policy makers struggle with competing challenges including state budget deficits and pressures to expand homeand community-based services (HCBS), there is a pressing need for information on the comparative cost of Medicaid HCBS and institutional care. This paper uses the most recent available data (2002) to present three per participant expenditure comparisons between Medicaid...

The Medicaid program is the largest payer of nursing home services in the nation. The magnitude of program spending and the anticipated program growth as the baby boom cohort ages have raised questions about how Medicaid affects private savings. This paper, which extends previous research, examines how high but uncertain nursing home expenses interact with Medicaid assistance to affect the savi...

Treatment costs for dental decay in young children can be substantial, especially if extensive dental procedures and general anesthesia in a hospital operating room (OR) are needed. Because caries in the primary dentition disproportionately affect children from low-income households, the cost for care frequently is reimbursed by state Medicaid programs. To determine whether the average treatmen...

Under the Affordable Care Act (ACA), states can expand Medicaid eligibility for nonelderly adults with incomes up to 138 percent of the federal poverty level (FPL). As of May 2016, 19 states had not expanded Medicaid. Based on reported Medicaid and marketplace data, we estimate that in 2017, even without the Medicaid expansion, the major coverage provisions of the ACA will have reduced the numb...