Exploring expanding coverage by integrating state Medicaid programs with federal tax credits

The purpose of this project is to explore ways to expand coverage by integrating state Medicaid programs with federal tax credits. The concept of a Medicaid+ tax credit approach was first identified in a 2003 paper in Health Affairs authored by Lynn Etheredge and Judy Moore. Two events since then have led a number of policy makers to suggest that such an approach offers a politically feasible way to expand coverage. First, data now shows that the erosion of employer-based insurance has meant rising Medicaid rolls and higher state budget costs. States have a big stake in stabilizing and promoting employer-based coverage. Second, President Bush has proposed a major initiative for expanding health insurance coverage using new federal tax credits--plus new state supplements--for individuals who do not participate in employer-based benefits or public programs. His budget includes $74 billion for individual tax credits, $23 billion for employer tax credits, and $4 billion for state purchasing pools. It also provides for state supplements of up to $2000/individual ($6,000/family) in addition to the federal tax credits. Integrating state Medicaid programs with federal tax credits would require state flexibility to re-design their Medicaid programs for this uninsured population. It also involves numerous design decisions around how it is implemented. This project will undertake to flesh out the different design options, the trade-offs of one option vs. another, and identify the critical decisions for implementation. The project will be considered successful if it produces critical thinking and viable options for the Medicaid+ tax credit approach.

Grant Details

Amount Awarded $258,129.00

Awarded on: 7/29/2005

Time frame: 8/1/2005 - 3/31/2007

Grant Number: 53788


George Washington University

2121 Eye Street, N.W.
Washington, 20052-1001


Sally Coberly
Project Director