Do welfare caseload declines make the Medicaid risk pool sicker?
Declining welfare caseloads may lead to a sicker population remaining in the Medicaid program, which could increase per enrollee costs and the level of adequate capitation rates. Using data from the 1997 National Survey of America's Families for adults and children, we examine differences in health status and utilization among welfare recipients and welfare leavers who did and did not retain Medicaid. We adjust utilization differences for insurance status and factors often used to adjust capitation rates. We conclude that declining welfare caseloads likely will result in a sicker and more expensive adult Medicaid risk pool.
Garrett
Bowen
B
Health Policy Center of the Urban Institute, Washington, DC 20037, USA.
Holahan
John
J
D000328:Adult; D002204:Capitation Fee; D002648:Child; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D015271:Insurance Pools / Q000639:trends; D015273:Insurance Selection Bias; D008329:Managed Care Programs / Q000191:economics / Q000706:statistics & numerical data*; D008484:Medicaid / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D012044:Regression Analysis; D020379:Risk Adjustment; D012720:Severity of Illness Index; D012946:Social Welfare / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D013221:State Health Plans / Q000191:economics; D014481:United States; D016526:Workload