Medicare and Medicaid: Trends and Issues Affecting Access to Care for Low-Income Elders and People with Disabilities

O'Brien, Ellen
March 2005
Generations;Spring2005, Vol. 29 Issue 1, p65
Academic Journal
The article reports that efforts to slow the growth of entitlement spending threaten access to care for the most vulnerable elderly and disabled beneficiaries in Medicare and Medicaid. Addressing rising federal costs for Medicare by shifting costs to beneficiaries fails to address the underlying cost problem in health care and will erode access for the most vulnerable beneficiaries with significant health care needs. Reliance on private plans has not saved money for Medicare in the past, and large increases in payments to private plans assure that they won't deliver Medicare cost savings in the future. In Medicaid, reduced federal contributions will lead many states to restrict eligibility or benefits for the elderly and disabled who account for the majority of program expenditures. States seeking flexibility through waivers to restrict benefits and raise cost sharing for optional populations may hit very low-income elderly and beneficiaries hard. Cost burdens are already high in Medicare and Medicaid beneficiaries are unlikely to be able to pay more of their own health care.


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