Welfare reform has had a less disruptive effect on Medicaid coverage than many critics had feared, according to a new report by the General Accounting Office.
No major disruption of Medicaid coverage under welfare reform.
No major disruption of Medicaid coverage under welfare reform
Welfare reform has had a less disruptive effect on Medicaid coverage than many critics had feared, according to a new report by the General Accounting Office. A major reason is that the Balanced Budget Act of 1997 addressed concerns over welfare reform and also created a new children's insurance program, the GAO said.
In its review of nine states, California, Connecticut, Florida, Georgia, Iowa, New Jersey, New York, Texas and Wisconsin, the GAO notes that the Balanced Budget Act blunted the impact of welfare reform by essentially restoring Medicaid eligibility to disabled children who had lost it and by securing it for aliens who were in the country before Aug. 22, 1996. States were given the option of not covering this group before passage of the Act.
The GAO cites one major disruption in Medicaid coverage, however, because of welfare reform. On Oct. 1, 1997, Georgia "inappropriately terminated Medicaid coverage for about 1,700 children who no longer met the SSI disability criteria." Georgia, which subsequently reinstated Medicaid coverage for the children, said it had terminated them because it was unable to obtain timely Social Security Administration data and because of internal problems with "recognizing the children's continued eligibility under the newly authorized category."
A major concern of critics of the new welfare reforms was that by delinking AFDC and Medicaid, people losing welfare or SSI benefits might lose their Medicaid coverage if they were not adequately informed or if the application processes were too complicated. But, according to the GAO report, eight of the nine states studied (Wisconsin was the exception) "chose to continue using a common application for their welfare and Medicaid programs and eight chose to continue using a single agency at the local level to determine applicant eligibility.
"The initial choices that these states made resulted in little structural change in their Medicaid programs."
The GAO report notes that delinking the programs does mean adjustments will be needed to establish separate welfare and Medicaid eligibility determinations.
"Although welfare reform authorized states to use private contractors to determine applicant eligibility for welfare, this authority was not extended to Medicaid, thus necessitating duplicative administrative processes in some cases.
"While the welfare reform law offered states the option of withholding Medicaid as a sanction for noncompliance with state work rules, as well as discontinuing Medicaid coverage for most aliens, none of the nine states chose to do so," according to the GAO report.
Copies of GAO/HEHS-98-62 are available on the Internet at www.gao.gov, or call 202-512-6000.
Welfare reform has had a less disruptive effect on Medicaid coverage than many critics had feared, according to a new report by the General Accounting Office.
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