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 1999-09-10 monographic deposited born digital 64 p. GA 1.13:HEHS-99-163 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-99-163 P0b002ee180391798 f:he99163 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-99-163 machine generated eng fdlp REPORT GAOREPORTS-HEHS-99-163 HEHS-99-163 Health insurance State-administered programs Disadvantaged persons Health care programs Surveys Federal/state relations Eligibility determinations Reporting requirements Workfare Public assistance programs State Children's Health Insurance Program HHS Temporary Assistance for Needy Families Program Aid to Families with Dependent Children Program Medicaid Program AFDC Letter Report HEHS Pursuant to a congressional request, GAO provided information on the decline in Medicaid enrollment, focusing on: (1) Medicaid enrollment changes for families and children following welfare reform, as well as associated key federal protections established for Medicaid; and (2) states' welfare-related policies and practices that can influence Medicaid enrollment.<p/>GAO noted that: (1) between 1995 and 1997, Medicaid enrollment declined nationwide, but substantially less than welfare participation; (2) overall, Medicaid enrollment among the nonelderly and nondisabled adults and children declined by about 7 percent, compared with a 23-percent decline in welfare participation; (3) shifts in individual states' Medicaid enrollment for these adults and children during this period ranged from a 19-percent decline in Wisconsin to a 26-percent increase in Delaware; (4) while most states experienced declines in Medicaid enrollment, enrollment increased in some states, in part as a result of individual state program expansions; (5) on the other hand, Medicaid and welfare enrollment declines have been attributed to strong state economies, low unemployment rates, and new state welfare-to-work initiatives; (6) the smaller declines in Medicaid enrollment may also be due to federal eligibility protections built into welfare reform and ongoing expansions of Medicaid coverage for low-income children that predate welfare reform; (7) one eligibility protection that predates welfare reform--transitional Medicaid assistance--provides an additional year of Medicaid coverage for individuals who lose Medicaid eligibility as a result of employment or increased income; (8) the extent to which transitional Medicaid has affected national enrollment trends, however, is uncertain because of the lack of uniform reporting and tracking of this entitlement; (9) GAO's analysis shows that changes in state-level welfare policies and practices can both positively and negatively influence Medicaid enrollment; (10) recognizing that the income reporting requirements can limit beneficiaries' access to the transitional Medicaid entitlement, the Health Care Financing Administration (HCFA) has submitted a legislative proposal to eliminate these requirements for up to 1 year; and (11) GAO's work shows that increased state flexibility to ease reporting requirements could facilitate the transition from welfare to work and make Medicaid more available to eligible individuals. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-99-163/html/GAOREPORTS-HEHS-99-163.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-99-163/pdf/GAOREPORTS-HEHS-99-163.pdf GAO/HEHS-99-163 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-99-163 Letter Report GAO/HEHS-99-163; Medicaid Enrollment: Amid Declines, State Efforts to; Health insurance State-administered programs Disadvantaged persons Health care programs Surveys Federal/state relations Eligibility determinations Reporting requirements Workfare Public assistance programs State Children's Health Insurance Program HHS Temporary Assistance for Needy Families Program Aid to Families with Dependent Children Program Medicaid Program AFDC Public Law 101-239 Public Law 101-508 Public Law 104-193