United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1995-04-04 monographic deposited born digital GA 1.13:HEHS-95-103 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-95-103 P0b002ee1803882a2 f:he95103 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-95-103 machine generated eng fdlp REPORT GAOREPORTS-HEHS-95-103 HEHS-95-103 Financial analysis Health care cost control Medicaid programs Federal/state relations Intergovernmental fiscal relations State-administered programs Financial management Welfare benefits Health services administration Block grants AFDC Aid to Families with Dependent Children Program Supplemental Security Income Program New Federalism Program Food Stamp Program Special Supplemental Food Program for Women, Infants, and Children WIC Job Opportunities and Basic Skills Training Program JOBS Program Letter Report HEHS Pursuant to a congressional request, GAO provided information on various proposals for restructuring the Medicaid Program, focusing on the: (1) different restructuring approaches and their implications for federal-state financing and program administration; and (2) need to establish a reserve fund to offset state tax losses and increased enrollments.<p/>GAO found that: (1) using block grants to fund state Medicaid programs would increase states' control over federal expenditures and administrative flexibility, which could result in increased operational efficiency and effectiveness; (2) on the other hand, if states reduce their Medicaid contributions, they would be more at risk for controlling program spending; (3) the block grant and cap proposals have not addressed how much administrative flexibility states would receive; (4) federalizing the Medicaid program would reduce program inequities and administrative costs, but the federal government would face difficulties in meeting localities' individual needs and operating conditions; (5) the impact of splitting Medicaid into long-term and acute-primary care programs would depend on the how the split is made and how responsibilities are distributed between the federal and state governments; (6) there has been little quantitative analysis on the potential effects of restructuring Medicaid on financing and administrative functions; and (7) states' Medicaid spending is sensitive to economic conditions and a reserve fund could be one way to assist states during economic downturns if strict limits are placed on federal contributions. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-95-103/html/GAOREPORTS-HEHS-95-103.htm GAO/HEHS-95-103 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-95-103 Letter Report GAO/HEHS-95-103; Medicaid: Restructuring Approaches Leave Many Questions; Financial analysis Health care cost control Medicaid programs Federal/state relations Intergovernmental fiscal relations State-administered programs Financial management Welfare benefits Health services administration Block grants AFDC Aid to Families with Dependent Children Program Supplemental Security Income Program New Federalism Program Food Stamp Program Special Supplemental Food Program for Women, Infants, and Children WIC Job Opportunities and Basic Skills Training Program JOBS Program