Medicare and Medicaid

Preface, Acknowledgments, 1 Background and History, The Historical Roots of Medicare and Medicaid, The 1965 Enactment of Medicare and Medicaid, Challenges for Implementation, State Medicaid Experimentation: A Departure from Freedom of Choice, Confronting Medicare Expenditures: The Prospective Payment System, Medicaid Reforms and Efforts to Control Costs, The Children's Health Insurance Program, Medicare's Prescription Drug Benefit: Part D, Medicare and Managed Care: Part C, Medicaid Expansion under the Affordable Care Act, Looking Back, Looking Forward, Sources, 2 Problems, Controversies, and Solutions, Problem #1: Medicare's Spending Is High and Not Well Controlled, Addressing Medicare's Budget, Option 1: Protect the Status Quo, Addressing Medicare's Budget, Option 2: Adopt a Public Insurance Option, Addressing Medicare's Budget, Option 3: Adopt a Premium-Support Model, Problem #2: Building Medicare for All Would Pose Multiple Challenges, Problem #3: Medicare Advantage Is Not Generating the Expected Savings, Problem #4: Medicare Part D Is Not Getting Taxpayers the Best Value for Their Money, Problem #5: Low Medicaid Reimbursement Levels Limit Patient Choice and Medical Provider Participation, Problem #6: Medicaid Is Not a Sustainable Way to Cover Long-Term Nursing Home Care, Problem #7: The Medicaid Expansion under the ACA Has Been Uneven, Problem #8: Medicare Experiences a High Level of Improper Payments, Conclusion, Sources, 3 Perspectives, My Journey on Medicaid, Aianna Zachary Medicaid and the Family Medicine Practice, Adam Houghton, MD A Nonprofit Clinic's Perspective on Medicare and Medicaid, Tory Lynch-Dahmm Closing the Gap in Health Care Access, Amanda F. Hopkins, PhD, RN Medicaid and Emergency Department Use, Mollie Ward, MDiv Medicaid Expansion: Nationalized Politics Meets Intergovernmental Reform, Philip Rocco, PhD Medicare from an Enrollee's Perspective, Ann C. The Growing Privatization of Medicare, Andrew Scholnick The American Health Care State, Robert Y. Shapiro, PhD 4 Profiles of People and Organizations, Introduction, The American Hospital Association, American Medical Association, Americans for Prosperity, America's Health Insurance Plans, Centers for Medicare and Medicaid Services, Healthcare-Now!, Kaiser Family Foundation, National Nurses United, Partnership for America's Health Care Future, Pharmaceutical Research and Manufacturers of America, Physicians for a National Health Program, Senator Bernie Sanders (b. September 8, 1941), UnitedHealth Group, Inc., U.S. Chamber of Commerce, Sources, 5 Data and Documents, Data, Figure 5.1. Medicaid Enrollment by Year (1968–2018), Figure 5.2. Medicaid Spending by Year (1968–2018), Figure 5.3. Medicaid Enrollment by Age Group as a Percentage of Total (2017), Figure 5.4. Medicare Enrollment by Year (1968–2018), Figure 5.5. Medicare Spending by Year (1968–2018), Figure 5.6. Medicare Advantage Enrollment (1999–2019), Figure 5.7. The Uninsured Rate (1997–2018), Figure 5.8. Enrollment in the Children's Health Insurance Program (1998–2018), Documents, President Lyndon Johnson's Remarks upon Signing Medicare and Medicaid into Law (1965), President Barack Obama's Remarks upon Signing the Patient Protection and Affordable Care Act into Law (2010), U.S. Senator Lamar Alexander on the Proposed Expansion of Medicaid (2009), U.S. Supreme Court Ruling in National Federation of Independent Businesses, et al. v. Kathleen Sebelius, Secretary of Health and Human Services,et al. (2012), Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (2019), National Health Expenditure Fact Sheet (2019), GAO Report on the Medicare Advantage Plan Finder (2019), 6 Resources, Broad Overviews of the Medicare and Medicaid Programs, History, Policy Reform Failures, Changes under the Affordable Care Act, Prescription Drug Coverage, Consumer-Driven Health Care, Financing and Coverage Challenges, Recent Politics and Policy, Commentary on Proposals for a Public Option Government Insurance Program and Analyses of Medicare for All Proposals, 7 Chronology, Glossary, Index,