Medicaid Expansion in Oregon

In early 2008, Oregon expanded it’s Medicaid eligibility.  To take advantage of these new benefits, 85,000 individuals signed up.  Oregon’s budget, however, only had enough money to fund Medicaid coverage for 30,000.  In a researcher’s dream case, Oregon decided to select the 30,000 eligible to apply for coverage using random assignment.  Because this policy in…

The Medicaid Integrity Program

One of President Obama’s biggest initiatives as part of health reform was to reduce fraud, waste and abuse in Medicare and Medicaid.  Today, I will discuss how the Medicaid program fights fraud at the federal level. Because Medicaid is state-run, the States have typically been the ones responsible for ensuring efficient Medicaid operations. However, the…

The Medicaid Medical Industrial Complex

“Across the nation, sizeable and forceful groups–a Medicaid medical industrial complex–support welfare medicine, many of them becoming entirely or partially dependent on its funding for their financial viability.  Their reliance on the low-income health program puts them at risk of adverse political decisions, but also drives them to exert disproportionate influence over policymakers. Vested interests–professionals,…

No Wrong Door

In Virginia, there are over one million people age 60 and older and over 90,000 Virginians age 85 and older. These figures will only grow in the upcoming decades.  Thus will put increasing strain on public programs and will require service providers to reorient medical care toward providing continued, high-quality long term care services.  Long…

Medicaid’s humble beginings

Although Medicaid is currently one of the largest programs in any state’s budget, Congress enacted this welfare health insurance scheme as almost an afterthought. Consider the news coverage for Medicaid at the time.  According to the chart below, the New York Times didn’t even mention Medicaid an any article in 1965 and Medicaid was mentioned…