State Alternatives to Medicaid Expansion

States are being encouraged to take the federal money and run — headlong into expanding their Medicaid program. However, this federal gravy train cannot go on forever. Chris Jacobs explains that states have other options when reforming health care within their states:

States are being encouraged to take the federal money and run — headlong into expanding their Medicaid program. However, this federal gravy train cannot go on forever. Chris Jacobs explains that states have other options when reforming health care within their states:

• Rhode Island got a waiver granting it the flexibility to use home and community-based services as an alternative to nursing homes.
• Indiana developed a program similar to consumer-driven health plans to provide coverage and the appropriate incentives to low-income populations.
• Florida successfully tested private managed care plans as a way to cover low-income families.

Lessons from other states are also evident from the early-stage experiments. According to Chris Jacobs, these follow a common theme:

• Customized Beneficiary Services.
• Coordinated and Preventive Care.
• Personal Responsibility.
• Home and Community-Based Services.
• No New Federal Funds.

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