title: Can States stretch the Medicaid dollar without passing the buck? Lessons from Utah.
abstract: In 2002, Utah became the first state to reduce benefits and increase cost sharing for existing Medicaid beneficiaries, to finance a primary care benefit expansion for previously ineligible, low-income adults. Through a 2004 survey of beneficiaries, we found that expansion enrollees were predominantly poor and that most suffered from chronic conditions or disabilities, or both. Parents whose coverage was reduced to finance the expansion were extremely poor, were in poor health, and faced major financial challenges. Findings suggest that a coverage expansion approach that relies on savings from reducing coverage for current beneficiaries and solely covers primary care has important limitations.
authors.affiliation: Kaiser Commission on Medicaid, Uninsured in Washington, DC, USA. sartiga@kff.org
authors.forename: Samantha
authors.initials: S
authors.lastname: Artiga
authors.forename: David
authors.initials: D
authors.lastname: Rousseau
authors.forename: Barbara
authors.initials: B
authors.lastname: Lyons
authors.forename: Stephen
authors.initials: S
authors.lastname: Smith
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Gaylin
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology; D017047:Cost Sharing / Q000331:legislation & jurisprudence*; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005251:Fees, Medical / Q000331:legislation & jurisprudence*; D005382:Financing, Personal / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008484:Medicaid / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000191:economics*; D013221:State Health Plans / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States; D014589:Utah