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Low-Income Adults: Can Medicaid Fill the Coverage Gap?

Monday, September 15, 2008

If you think that all poor Americans can get health coverage through Medicaid, think again. Except in a few states with federal waivers, adults must not only meet income and asset requirements, but must fit into a category of persons for which coverage is available.

If they are not parents of dependent children, disabled or elderly, they do not qualify for Medicaid coverage, no matter how poor. As a result, more than half of all low-income uninsured persons are adults who do not fit in current eligibility categories as defined by federal law.

A recent study estimates that almost 16 million uninsured adults age 18-64 have a chronic illness. Those without a way to pay for care have limited access to physicians; others use hospital emergency rooms when their untreated conditions become catastrophic. According to most analysts, unmanaged chronic illness is a source of inefficiency in our system and contributes to the high cost of care.

Can Medicaid be redesigned to cover non-categorical poor adults? What lessons can be learned from states’ efforts to cover the uninsured through Medicaid expansions? What are the challenges they have faced and are likely to face in the current economic climate? Can private insurance fill the void?

To address these and related questions, the Alliance for Health Reform and the AARP Public Policy Institute sponsored a September 15 briefing. A special focus of the briefing was a new AARP Public Policy Institute research report, Millions of Poor Americans Can’t Get Medicaid: What Can Be Done? Speakers will be: Stan Dorn of the Urban Institute and author of the new report; Barbara Coulter Edwards of Health Management Associates; Nina Owcharenko of the Heritage Foundation; and Gary Ferguson of American Viewpoint. Co-moderators will be Susan Reinhard, head of the Public Policy Institute, and Ed Howard of the Alliance.


 Susan Reinhard, AARP Public Policy Institute, Moderator
 Ed Howard, Alliance for Health Reform, Moderator
 Stan Dorn, Urban Institute, Speaker
 Barbara Coulter Edwards , Health Management Associates, Speaker
 Nina Owcharenko , Heritage Foundation, Speaker
 Gary Ferguson, American Viewpoint, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Low-Income Adults: Can Medicaid Fill the Coverage Gap? (Adobe Acrobat PDF), 9/15/2008
Event Summary: Low-Income Adults: Can Medicaid Fill the Coverage Gap? (Word Document), 9/15/2008
Full Webcast/Podcast: Low-Income Adults: Can Medicaid Fill the Coverage Gap?

The transcript, full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Stan Dorn Presentation (PowerPoint), 9/15/2008
Barbara Edwards Presentation (PowerPoint), 9/15/2008
Gary Ferguson Presentation (PowerPoint), 9/15/2008

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Low-Income Adults: Can Medicaid Fill the Coverage Gap? (Word Document), Microsoft Word, 9/15/2008
Sourcelist (Adobe Acrobat PDF), , 9/15/2008

Offsite Materials (briefing documents saved on other websites)

Uninsured Young Adults: A Profile and Overview of Coverage Options (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 6/1/2008
Medicaid and Other Public Programs for Low Income Childless Adults (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 8/1/2004
Financing State Coverage Expansions: Can New Medicaid Flexibility Help? (Adobe Acrobat PDF),National Academy for State Health Policy, 9/1/2007
The Medicaid Program: A Brief Overview (Adobe Acrobat PDF),AARP, 7/1/2007
Spotlight on Uninsured Parents (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 6/1/2008
Public And Private Health Insurance: Stacking Up The Costs, Health Affairs, 6/24/2008
Toward Real Medicaid Reform, Health Affairs, 2/23/2007
Government and Health Care: The Good, The Bad, and the Ugly, CATO Institute, 11/28/2007
Doctors Aren't In for Medicaid Patients, The Wall Street Journal, 7/19/2007
NGA's Medicaid Reform Principles, National Governors Association, 3/5/2007
The Tax Equity and Affordability Act: A Solution for the Uninsured, The Heritage Foundation, 8/30/2006
The Medicaid Regulations: Stopping the Abuse of Taxpayers' Dollars, The Heritage Foundation, 5/2/2008
State Health Care Reform: Retargeting Medicaid Hospital Payments , The Heritage Foundation, 8/29/2008
Health Care Reform: Design Principles for a Patient-Centered, Consumer-Based Market, The Heritage Foundation, 4/23/2008
We're not home yet, Modern Healthcare, 4/21/2008


Susan Reinhard of AARP's Public Policy Institute, co-moderator at the Sept. 15 briefing co-sponsored by the Institute.

Stan Dorn of the Urban Institute discusses highlights of a new report from the AARP Public Policy Institute, "Millions of Poor Americans Can’t Get Medicaid: What Can Be Done?" (12 min.) From the Sept. 15 briefing co-sponsored by AARP.


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