States Face Tough Choices as Medicaid Burden Shifts

Conference to assess the impact of budget cuts and structural changes in Medicaid

In 1996, senior state health officials from eight states and from health policy organizations convened to assess the potential impact of budget cuts and structural changes resulting from the shifting of responsibilities for Medicaid from the federal government to the states through the use of block grants.

The conference was co-funded with in-kind support from the Rockefeller Institute, the Rockefeller College of the State University of New York and the Brookings Institution.

Key Results and Findings

  • The conference, "Devolution and Medicaid: A View from the States," took place on May 22–24, 1996, in Washington. Twenty senior state health officials from eight states and from health policy organizations attended. Among the findings:
    • The shift of Medicaid responsibilities to the states may well bring a reduction in payment rates to safety net institutions such as public hospitals and community health centers.
    • Political obstacles and the limits to state administrative capacity make it difficult to apply managed care to the disabled and elderly institutionalized populations, who consume the largest portion of the Medicaid budget.
    • Existing knowledge about state government capabilities and proclivities does not permit precise predictions about the response of the states to greater Medicaid authority.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $110,675 to the Research Foundation of State University of New York.

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