Expert Voices: Medicaid Expansion: What's at Stake for 2014 and Beyond?
If these states follow their governors’ pronouncements, an estimated 6.4 million low-income, uninsured adults are at risk of remaining without insurance. Hospitals, employers and the privately insured also stand to lose in states that opt out. In this essay, two former state Medicaid directors examine the Medicaid expansion from different stakeholder perspectives and offer evidence of the sustained financial benefits that can accrue to states accepting federal funding to expand Medicaid eligibility. By Joan Henneberry, MS, Principal, Health Management Associates, and Kathy D. Gifford, JD, Managing Principal, Health Management Associates, April 2013.
On July 19, 2011 NIHCM Foundation hosted a webinar, "Medicare and the Federal Deficit." Our federal government is spending vastly more than it is taking in, resulting in huge annual deficits that must be covered by borrowing. We now borrow about 41 cents for every dollar we spend and have reached our legal debt limit of more than $14 trillion, forcing contentious standoffs over raising the debt ceiling. The Congressional Budget Office predicts that our public debt will reach 70 percent of GDP this year and could exceed GDP within a decade – rivaling debt levels last seen during World War II. With Medicare spending accounting for 13 percent of federal spending or 3.7 percent of GDP today and projected to reach about 7 percent of GDP by 2035, this program is a significant contributor to our fiscal woes and an inescapable part of any solution.
Through presentations from three national experts, participants:
- learned how Medicare affects our fiscal outlook,
- heard about new data showing the large imbalance between lifetime Medicare benefits and contributions, and
- explored the range of Medicare reform options now under discussion and the political outlook for enacting reforms.
In response to interest in Medicaid and Medicare reforms, NIHCM Foundation has funded policy research, organized forums and co-sponsored conferences on managed care best practices in serving these populations. Efforts include a white paper and a forum, "Developing Medicaid Managed Care Networks: Strengthening Relationships Between Plans and Traditional Community Providers," co-sponsored with the Health Resources Services Administration and the Maternal and Child Health Bureau. A paper reporting on the discussion at this forum appeared in Health Affairs. NIHCM Foundation plans to continue similar activities to improve health care to Medicare and Medicaid beneficiaries. See Medicare and Medicaid Publications for copies of reports, proceedings and fact sheets.