“Local Governments Play An Important Role In Medicaid Financing,” by Jessica Schubel, Health Affairs
“Over the course of Medicaid’s 60-year history, financing requirements and rules have evolved. Although the language about the non-federal share goes back to the beginning of Medicaid, major changes were adopted by Congress in 1991 that largely impacted the use of health care-related provider taxes and specifically preserved states’ ability to use of IGTs and CPEs by restricting CMS’s ability to regulate them. In 1994, the Government Accountability Office investigated the use of IGTs and CPEs in three states and identified a questionable financing strategy that appeared to increase the federal share of Medicaid spending, raising concerns about whether these federal dollars were actually serving Medicaid beneficiaries. As a result, in 2002, CMS began using a standard set of funding questions when states requested to make changes to their payment methodologies. These questions clarify the source of funding for the non-federal share as well as provide detailed information on funds transferred from other government entities via IGTs and CPEs.”
LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform:
Read this article for an overview of Medicaid’s complicated funding structure. Read criticism of that structure by the Paragon Health Institute. Now ask yourself: why are the Health Affairs authors so eager to defend this indefensible funding system and so unwilling to consider genuine reform? For the long-term care part of this picture, you can find answers in the Paragon Health Institute’s “Long-Term Care: The Problem” and “Long-Term Care: The Solution” and watch this “virtual LTC event” featuring age wave visionary Ken Dychtwald and leading LTC researchers. To find ample private funds for LTC, check out “Medicaid’s $100+ Billion Leak.” For what not to do, see “Medi-Cal-amity: California’s Reckless Expansion of Medicaid Long-Term Care to the Affluent.” Much more on long-term care here.