Medicaid
The joint federal-state Medicaid program provides health coverage for more than 55 million low-income Americans, mostly pregnant women, children, people with disabilities and the elderly. Increasing enrollment and rising healthcare costs continue to put financial pressure on states and the federal government to sustain the growth in the Medicaid program.
Leaders at the federal and state levels are implementing reforms to secure the long-term stability of the program. The Deficit Reduction Act (DRA), signed into law in February 2006, changed many aspects of the Medicaid program, including modifications intended to make it easier for states to enroll Medicaid beneficiaries in private coverage. States continue implementing approaches to reduce unnecessary utilization, contain costs, improve access to services, and achieve greater continuity of care. Private health plans and states are working together to deliver Medicaid benefits – nearly two-thirds of all Medicaid beneficiaries are served through managed care.
SCHIP
The State Children’s Health Insurance Program (SCHIP) is a federal-state program that provides health coverage for more than 7 million Americans, mostly children who live in families with incomes above Medicaid eligibility levels. States implement SCHIP either as an expansion of their Medicaid program, a separate stand-alone program that expands coverage through public-private partnerships, or a combination of both approaches. Modifications in SCHIP eligibility levels and changes in outreach and enrollment strategies have resulted in fluctuating fiscal demands on the decade old program.
Initially funded for ten years beginning in 1997, Congress is currently considering legislative proposals for reauthorization of the program. As states implement approaches to health reform, many states have adopted plans to use SCHIP funding to expand coverage through public-private partnerships.
Blue Cross and Blue Shield Plans partner with states to provide coverage to millions of Medicaid and SCHIP beneficiaries. Collectively, Blue Cross and Blue Shield Plans have always been the single largest provider of managed care services to Medicaid beneficiaries, providing services to an estimated 10 percent of the Medicaid managed care population. In SCHIP, nearly one-third of SCHIP beneficiaries receive services through Blue Cross and Blue Shield Plans. BCBSA supports:
- Expanding Medicaid and SCHIP by making it easier for states to adopt premium assistance programs that assist eligible families in affording coverage offered by their employer.
- Expanding Medicaid to cover all individuals below the federal poverty level in states. This would include pregnant women and childless adults who typically do not qualify for coverage under current eligibility requirements.
- Adequate funding for the Medicaid and SCHIP programs. BCBSA believes that adequate Medicaid and SCHIP funding is necessary to: (1) support outreach and enrollment efforts (2) minimize cost-shifting; and (3) continue the participation of private health plans in Medicaid and SCHIP.
BCBSA Policy and Positions:
