Government Involvement in Health Care

1
Government Involvement in Health Care

• Part Two

2
Medicaid
State Govt
Fed Govt

• Title XIX of the Social Security Act
• Health Care program for certain low income
  persons (NEED based program)
• Administered by each state
• Federal mandates
• State options
• Funded by Federal and State Government

3
Medicaid
State Govt
Fed Govt

• Groups Eligible Mandatory
• Temporary Assistance for Needy Families (TANF) 1
  parent households with income below x
  http//www.nccp.org/policy_index_12.html
• Supplemental security income (SSI)
• Aged Needy, Blind Needy, Disabled Needy
• Children lt 6, pregnant women, family income
  133 FPL (FPL on next slide)
• Children lt19, income FLP
• Some foster care children
• Many states are expanding eligibility (SCHIP)

4
2004 HHS Poverty Guidelines
Fed Govt
Size of Family Unit 48 States Alaska Hawaii
1 9,310 11,630 10,700
2 12,490 15,610 14,360
3 15,670 19,590 18,020
4 18,850 23,570 21,680
5 22,030 27,550 25,340
6 25,210 31,530 29,000
7 28,390 35,510 32,660
8 31,570 39,490 36,320
5
Medicaid
State Govt
Fed Govt

• Mandatory Services
• Inpatient hospital care
• Physician services
• Diagnostic services
• Skilled Nursing Facility Services
• Rural Health Clinic Services
• Family Planning

• Optional Services
• Chiropractors
• Dental
• Eye Glasses
• Intermediate Care Facilities
• Occupational Therapy
• Physical Therapy
• Podiatrists
• Prescription Drugs
• Rehabilitation Services

6
Medicaid
State Govt
Fed Govt

• Federal Government pays 50-83 of costs depending
  on the state
• Federal Match in Nebraska is 60 (62.8 for
  fiscal year 2004)
• 47 of recipients are children, low incomes
• 15 of the dollars go here
• 27 of recipients are aged or disabled
• Consume 73 of the dollars
• A large portion of Medicaid in Nebraska is Long
  Term Care patients

7
NE Medicaid Expenditures
State Govt
www.cms.hhs.gov/medicaid/msis/mstats.asp
(Accessed 9/3/04)
8
U.S. Medicaid Expenditures
Fed. Govt.
www.cms.hhs.gov/medicaid/msis/mstats.asp
(Accessed 9/3/04)
9
U.S. Expenditures Compared to Number of
Recipients - Medicaid
Fed. Govt.
-
www.cms.hhs.gov/medicaid/msis/mstats.asp
(Accessed 9/3/04)
10
Other major Federal Health Coverage Plans
Fed. Govt.

• Veterans Administration
• Dept. of Defense (Military Services) Tri-Care
  Formerly CHAMPUS (Military Dependents)
• Federal Employee Plan
• Indian Health Service / U.S. Public Health
  Service
• State Local Plans for poor and uninsured.

11
Government Involvement in Health Care

• This concludes Part Two