From Crunch to Crisis: State Budgets, Medicaid and the Economy

Medicaid programs are feeling the strain as enrollment grows while state revenues come in lower than projected. This briefing, cosponsored by the Kaiser Commission on Medicaid and the Uninsured, looked at the recession’s effect on Medicaid programs and low-income individuals and families.

Children’s Health Coverage: Medicaid, CHIP, and Next Steps

Medicaid and the Children’s Health Insurance Program (CHIP) play a crucial role in the U.S. health insurance system by providing coverage for more than one in four children. The number of children in CHIP is at an all-time high, having grown 15 percent over the past year alone. About half of Medicaid’s enrollees are children. And yet, more than 8 million children remain uninsured today, 70 percent of whom are eligible for Medicaid or CHIP.

Medicaid: The Essentials

As a state-run program with broad federal guidelines, Medicaid covers health and long-term care services for scores of millions of low-income Americans. Conversations are well underway about the role of Medicaid as a vehicle for economic stimulus, and about its role in health coverage expansion proposals. In that context, a grounding in current Medicaid basics will be essential to congressional health staff, reporters covering health issues and others concerned about health coverage.

Children’s Health Coverage: A Primer

Medicaid and the State Children’s Health Insurance Program (SCHIP) play a crucial role in the U.S. health insurance system by providing coverage for more than one in four children. During 2005, about 29 million children were enrolled in Medicaid at some point in the year and more than 6 million were covered through SCHIP. Though more than 65 percent of children in the U.S. are covered by private insurance (most through their parents’ employers), Medicaid and SCHIP have helped to increase health care coverage for millions of children.

Medicaid as Stimulus: A Tonic for What Ails the Economy?

Because of the way Medicaid is financed, a recession means double trouble. States have reduced revenue, and thus less money to spend on Medicaid, just as more people are losing their jobs and their health coverage, and need the program. States have little choice but to cut Medicaid spending. Unlike the federal government, they are required by their constitutions to balance their budgets annually, and Medicaid is one of the largest budget components.

Low-Income Adults: Can Medicaid Fill the Coverage Gap?

If you think that all poor Americans can get health coverage through Medicaid, think again. Except in a few states with federal waivers, adults must not only meet income and asset requirements, but must fit into a category of persons for which coverage is available.

Dental Health: Nurturing the Health Care System’s Neglected Stepchild

The recent deaths of two children due to preventable dental conditions focused attention on the importance of improving access to dental coverage for low-income Americans. With SCHIP reauthorization on the horizon and the chance that elements of last year’s vetoed SCHIP proposal—which included provisions for dental care—may be revived, oral health issues are front and center.

A Reporter’s Toolkit: Child Health Coverage

This toolkit, supported by the Robert Wood Johnson Foundation, offers links to resources that will help you understand how children in the U.S. get health coverage, and the importance of employer-sponsored coverage and public programs to children. We offer an overview of the State Children’s Health Insurance Program (SCHIP), with an update on congressional reauthorization of the program. This resource also offers key facts, story ideas for reporters, selected experts with contact information, selected websites, and a glossary.

A Reporter’s Toolkit: Medicaid

A Reporter’s Toolkit: Medicaid This toolkit, supported by the Robert Wood Johnson Foundation, will help you understand who the Medicaid program covers, how it is financed, how it differs from Medicare, how states can alter Medicaid through federal waivers, and what the future holds for the program. This resource also offers key facts, brief background, story ideas, selected experts with contact information, selected websites and a glossary.

A Reporter’s Toolkit: The Uninsured

This toolkit, supported by the Robert Wood Johnson Foundation, is designed for reporters covering health issues during Campaign 2008, but will be useful for others looking for up-to-date resources on the uninsured. The toolkit features dozens of links to useful websites and articles, including links to websites tracking presidential candidates’ health reform plans. It also includes key facts, background, story ideas, lists of experts and websites, and a glossary.

Changing the Culture and Improving Quality: Innovations in Long-Term Care

Culture change in the long-term care world involves many players – residents, administrators, workers, lawmakers, policy analysts – sharing a common vision. One such vision attracting attention has been developed by a group of citizens, providers and advocates known as Pioneers who are exploring alternatives to traditional nursing facilities. Their goal: facilities that are resident-centered, less institutional and more home-like. This involves trying to piece together financing from Medicaid, Medicare and private funding sources.

Crowd-out and SCHIP

Congress and the White House are gridlocked on SCHIP reauthorization beyond November. President Bush has vetoed the first SCHIP bill to cross his desk. CMS has issued tough new rules governing when states can open up their SCHIP programs to children above 200 percent of the federal poverty. One reason for all of the above: crowd-out – the phenomenon of people dropping private health coverage when public coverage becomes more easily available. This toolkit, supported by the Robert Wood Johnson Foundation, helps explain why crowd-out occurs and offers links to late-breaking developments affecting SCHIP enrollment. A list of experts and websites is also included.

Massachusetts Health Reform

Starting July 1, every adult in Massachusetts is required to have health coverage (except for 60,000 people exempted by the state). This toolkit, supported by the Robert Wood Johnson Foundation, is designed to help you understand the state's pace-setting near-universal coverage plan and its implications, with links to representative articles and documents from across the ideological spectrum. You will also find a list of selected experts and websites. We recommend these articles and experts to you, and welcome your suggestions for additions to our list. You may email those to

State Health Initiatives: What’s Next?

New initiatives are cropping up in one state after another aimed at helping the uninsured. The most comprehensive efforts have been in Massachusetts, Vermont and Maine. California Gov. Arnold Schwarzenegger has attracted national attention for his plan to cover virtually all in that state, and legislative leaders have their own plans. But many other states are also moving toward expanded coverage.

Which Way To Turn? Options for Rebuilding the Gulf Region’s Health Infrastructure

More than two years after hurricane Katrina devastated the Gulf region and destroyed large swaths of New Orleans, local and federal officials are trying to determine the appropriate approach to rebuilding the health care system. Prior to Katrina, Louisiana’s health care infrastructure was a two-tiered system. The middle class relied largely on the private health care system while the poor relied on a state-sponsored hospital network known as the “Charity” system.

Medicaid 101: A Primer on the Health Insurance Program for Low-Income Americans

Medicaid is a joint state and federal program. It covers nearly 55 million individuals – children, adults with children, elderly and disabled individuals and cost nearly $300 billion in combined state and federal spending in 2006. Whom does Medicaid serve? What benefits does Medicaid cover? How is it financed? What is the nature of the federal and state partnership?

SCHIP and Beyond: Improving Health Care Coverage and Quality for Children

Dollar for dollar, providing better health care for children represents one of the best returns on investment available in the U.S. This involves not only better monitoring of quality and making quality improvements, but also enrolling eligible children in health programs such as SCHIP and Medicaid. And it means ensuring that health care systems – including safety net providers and health insurers – are responsive to the unique health needs of children.