State Medicaid Lessons For Federal Health Reform

The objective of this Blog post is to summarize these lessons. Health Savings Accounts And Cost Sharing Several states, including Arkansas, Indiana, and Michigan, have used 1115 waivers to implement HSAs, monthly contributions, and cost sharing, typically in the form of copays. In these states, Medicaid enrollees in certain eligibility categories make monthly contributions to their accounts instead of making payments to an insurer. Most states also contribute to the accounts. These contributions typically are used to cover enrollees’ copays, but in a few states, contributions accrue in the account and can be disbursed back to the enrollee upon departure from the program. Unlike traditional HSAs, Medicaid HSAs do not provide a tax advantage and enrollees receive care without regard to a deductible. Opportunities HSAs and cost sharing are generally promoted as having three purposes: they may 1) increase enrollees’ responsibility for their health coverage, 2) familiarize enrollees with private insurance models, and 3) reduce costs to the state. The concept behind HSAs and cost sharing is that enrollees have an incentive to use funds in their accounts thoughtfully because they can be rolled over and used for health care services needed in the future. This approach is intended to encourage people to be careful consumers of services and to reduce unnecessary utilization. Challenges Lower-income individuals are especially sensitive to cost sharing. Research shows that cost shari...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Featured Medicaid and CHIP Payment Policy Quality Arkansas Healthy Indiana Plan Michigan Section 1115 Waivers Source Type: blogs