Medicaid Reform Case Study
The Clinton Administration has dedicated to strengthening and improving Medicaid so that it can fulfill the promise of our nation to millions of children, elderly, and disabled Americans and their families. To achieve this goal, this Administration has worked vigorously in partnership with the states to test innovative new approaches to delivering and financing care for Medicaid patients. During our first 3 years in office, this Administration approved 91 major Freedom of Choice waivers and waiver renewals, which allow states to enroll beneficiaries in managed care plans. We have also approved 163 new and renewed Home and Community-Based Services waivers, which enable states to use home care as an alternative to costly nursing home care, and
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The dramatic changes in welfare have the potential to affect not only the economic but also the social and health status of low-income people.
Moreover, this striking reform also provides a living lesson in the devolution of public policy management from the federal government to states and localities. One of the most contentious elements of the welfare reform debate in 1995 and 1996 revolved around the Medicaid program. Would it be tied to welfare reform and block granted along with cash payments? Should the Medicaid program be considered a health …show more content…
Work requirements are key, and PRWORA requires states to orient their programs around employment. Penalties are levied if a state fails to achieve minimum work participation rates among clients. There is a five-year lifetime cap on receipt of TANF benefits, and states must require most recipients to participate in work or work-related activities within two years in order to receive benefits. States have the option of requiring work immediately and may terminate all assistance for noncompliance. Great flexibility is afforded states to structure their own programs to meet the purposes of TANF. Thus, states define their own criteria for eligibility and services and may expand or deny services entirely to certain groups. In this way, states can define their benefits and expend funds to meet their own priorities. In addition to the primary emphasis on work, PRWORA stresses support for family stability,
The subject of Medicaid eligibility is extremely difficult. Years ago, before many recent confounding complications were added, Medicaid eligibility rules
The dramatic changes in welfare have the potential to affect not only the economic but also the social and health status of low-income people.
Moreover, this striking reform also provides a living lesson in the devolution of public policy management from the federal government to states and localities. One of the most contentious elements of the welfare reform debate in 1995 and 1996 revolved around the Medicaid program. Would it be tied to welfare reform and block granted along with cash payments? Should the Medicaid program be considered a health …show more content…
Work requirements are key, and PRWORA requires states to orient their programs around employment. Penalties are levied if a state fails to achieve minimum work participation rates among clients. There is a five-year lifetime cap on receipt of TANF benefits, and states must require most recipients to participate in work or work-related activities within two years in order to receive benefits. States have the option of requiring work immediately and may terminate all assistance for noncompliance. Great flexibility is afforded states to structure their own programs to meet the purposes of TANF. Thus, states define their own criteria for eligibility and services and may expand or deny services entirely to certain groups. In this way, states can define their benefits and expend funds to meet their own priorities. In addition to the primary emphasis on work, PRWORA stresses support for family stability,
The subject of Medicaid eligibility is extremely difficult. Years ago, before many recent confounding complications were added, Medicaid eligibility rules