Medicaid

The federal-state Medicaid program provides health coverage for nearly 46 million lower-income Americans who would otherwise be uninsured and unable to afford care. Approximately 20 million Medicaid recipients were enrolled in private plans as of June 2006. The number of Medicaid recipients enrolled in managed care plans continues to grow. Enrollment in these plans increased by about 5 percent in 2006 and grew by over 14 percent in the last three years.

By enhancing access to providers and emphasizing preventive and routine care, health plans have successfully improved the quality of care received by enrollees in the Medicaid managed care program. Independent research and government-sponsored surveys demonstrate that health plans have improved access to services and the health status of Medicaid recipients. For example:

• Enrollees in New York Medicaid health plans were found to be more than twice as likely to have received cervical cancer screening and diabetes monitoring than enrollees in the fee-for-service program. 
  
  
• A service management program offered by a Medicaid health plan in Pennsylvania has led to the increased identification of patients with sickle cell disease, a 35 percent increase in the use of physician office visits, home care and laboratory services, while emergency room visits fell by 50 percent and inpatient hospital services were reduced by nearly 20 percent. 
  
  
• An asthma management program operated by a Medicaid health plan in Minnesota increased the number of participants taking the appropriate controller medication by 12 percent while decreasing the asthma-related hospital admissions by 25 percent.
  With innovative programs and stubborn determination, health plans are working to make Medicaid more effective: reaching out to single parents and underserved children, to the elderly and people with disabilities, to patients struggling with chronic illnesses who have never had ongoing relationships with caring health professionals – and offering them the advantages of comprehensive services and coordinated care.

Moving forward, AHIP strongly supports initiatives to expand access to health care to the 3 million adults and 6 million children who are eligible for, but not enrolled in the Medicaid or State Children's Health Insurance (SCHIP) programs. We also strongly support adequately funding state Medicaid programs. Fully funding Medicaid will ensure that the important safety net that state programs provide will remain viable, and those with low incomes will be able to continue to receive necessary health care services.