What determines eligibility for Medicare?

Question

Instructions

Required Reading:

 Wilensky, S.E. & Teitelbaum, J.B. (2020). Essentials of Health Policy and Law , Ch. 11.   

Reading Questions to answer:

1.     What determines eligibility for Medicare?

2.     What are the different components of Medicare and how are they each financed?

3.     What determines eligibility for Medicaid and for CHIP?

4.     How are Medicaid and CHIP financed and administered?

Further Reading:

Strongly Recommend:

            *Moniz, C. & Gorin, S., 2014. Health Care Policy and Practice, 6 & 7: read the chapter summaries!!

            *Grogan & Andrews, ‘Medicaid,’ in Béland, D., et al. Eds., 2014. Oxford Handbook of U.S. Social Policy

            *Oberlander, ‘Medicare,’ in Béland, D., et al. Eds., 2014. Oxford Handbook of U.S. Social Policy

            *Rudowitz et al. 2019, ‘10 Things to Know about Medicaid: Setting the Facts Straight’ (KFF)

            CMS. ‘Medicare and Your Mental Health Benefits’ (2 pps)

https://www.medicare.gov/Pubs/pdf/11358-Medicare-Mental-Health-Getting-Started.pdf

            Cubanksi, J. and Freed, M. May 5, 2020. FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment. https://www.kff.org/coronavirus-covid-19/issue-brief/faqs-on-medicare-coverage-and-costs-related-to-covid-19-testing-and-treatment/

            Teigland, C. et al. May 13, 2020. ‘As it Grows, Medicare Advantage Is Enrolling More Low-Income and Medically Complex Beneficiaries.’ Commonwealth Fund

https://www.commonwealthfund.org/publications/issue-briefs/2020/may/medicare-advantage-enrolling-low-income-medically-complex – See update

Overview of Medicaid Expansion

            *Guth, M. et al. 2020. ‘The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review’ read ‘Key Findings’

            Andrews, C. (2014). Unintended consequences: Medicaid expansion and racial inequality in access to health insurance. Health & Social Work 39 (3), 131-133.

Garfield & Orgera, 2020 ‘The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid’ (KFF).

            *Grogan & S. Park, 2017. ‘The Racial Divide in State Medicaid Implementation,’ Journal of Health Politics, Policy and Law, 42, 3, 2017, READ ABSTRACT & Conclusions, pp. 539-541; 560-561.

            KFF, 2020, Who Could Get Covered Under Medicaid Expansion?: State Fact Sheets’

            Zelizer, Julian, ‘How Medicare Was Made,’ New Yorker, Feb. 15, 2015.

READING TBA: FURTHER BIDEN ADMIN ACTIONS

Useful Websites:

            Center for Medicaid and Medicare (CMS) https://www.cms.gov/

            Medicare  https://www.medicare.gov/index

            Medicaid https://www.medicaid.gov/

            Medicaid.gov ‘Behavioral Health Services’ (1 p)

https://www.medicaid.gov/medicaid/benefits/behavioral-health-services/index.html

            Dolan, R. and Artiga, S. May 22, 2020. ‘State Actions to Facilitate Access to Medicaid and CHIP Coverage in Response to COVID-19.’ KFF. https://www.kff.org/coronavirus-covid-19/issue-brief/state-actions-to-facilitate-access-to-medicaid-and-chip-coverage-in-response-to-covid-19/

Read one:

            Hinton E., et al 2019. ‘10 things to know about Medicaid Managed Care’ KFF https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-managed-care/

            Wagner, J. May 13, 2020. ‘Streamlining Medicaid Enrollment During Covid-19 Public Health Emergency, CBPP. https://www.cbpp.org/research/health/streamlining-medicaid-enrollment-during-covid-19-public-health-emergency

            Lewis, C. May 15, 2020. ‘Eyeing Medicaid Cuts, Cuomo Puts His Stamp on A $3 Trillion Stimulus Package.’ Gothamist.

https://gothamist.com/news/eyeing-medicaid-cuts-cuomo-puts-his-stamp-3-trillion-stimulus-bill