1. Government Involvement in Health Care Part Two

2. State Govt Fed Govt Medicaid 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 Groups Eligible – Mandatory –Temporary Assistance for Needy Families (TANF) 1 parent households with income below “x” http://www.nccp.org/policy_index_12.html 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) State Govt Fed Govt

4. 2004 HHS Poverty Guidelines Size of Family Unit 48 States Alaska Hawaii 1$9,310$11,630$10,700 212,49015,61014,360 315,67019,59018,020 418,85023,57021,680 522,03027,55025,340 625,21031,53029,000 728,39035,51032,660 831,57039,49036,320 Fed Gov t

5. Medicaid 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 State Govt Fed Govt

6. Medicaid 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 State Govt Fed Govt

7. NE Medicaid Expenditures www.cms.hhs.gov/medicaid/msis/mstats.aspwww.cms.hhs.gov/medicaid/msis/mstats.asp (Accessed 9/3/04) State Govt

8. U.S. Medicaid Expenditures www.cms.hhs.gov/medicaid/msis/mstats.aspwww.cms.hhs.gov/medicaid/msis/mstats.asp (Accessed 9/3/04) Fed. Govt.

9. U.S. Expenditures Compared to Number of Recipients - Medicaid www.cms.hhs.gov/medicaid/msis/mstats.aspwww.cms.hhs.gov/medicaid/msis/mstats.asp (Accessed 9/3/04) - Fed. Govt.

10. Fed. Govt. Other major Federal Health Coverage Plans 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