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Administering a Medicaid + Tax Credits Initiative

A joint publication of the Health Insurance Reform Project at The George Washington University and the National Academy for State Health Policy For the past several years, there has been interest in proposals that would cover the uninsured through a combination of new federal health insurance tax credits and expansion of state Medicaid and State Children’s Health Insurance (SCHIP) programs. Joining these two approaches may be the only way to reach an enactable compromise. This report presents the results of a project that focused on the issues and problems of administering such initiatives. The study was undertaken because implementing a nationwide “Medicaid + Tax Credits” initiative to cover 47 million uninsured persons, in more than 50 federal-state programs, would pose unprecedented, large, and complex administrative challenges for both the public and private sector. The report includes a vision for a world-class administrative system and offers specific suggestions for administrative efficiency in the areas of eligibility rules, application and enrollment, premium payment, consumer choice, and other issues. It is intended to foster an early and critical dialogue between policymakers and administrators.    
Lynn Etheredge
Judith Moore
February 2007
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Medicaid Tax Credits840.02 KB