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Government Involvement in Health Care

Government Involvement in Health Care. Part Two. 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.

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Government Involvement in Health Care

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  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 < 6, pregnant women, family income ≤ 133% FPL (FPL on next slide) • Children <19, income ≤ FLP • Some foster care children • Many states are expanding eligibility (SCHIP)

  4. Fed Govt 2004 HHS Poverty Guidelines

  5. 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 Medicaid State Govt Fed Govt

  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

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