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North Carolina medical journal v.78 no.1, 2017년, pp.14 - 15  

Federal Medicaid Reform : Potential Changes and Impact on North Carolina

Zolotor, Adam J. ; Yorkery, Berkeley ; Benbow, Lauren ;
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    The future of health care, which has been a contentious issue for many years, now appears to be headed in a new direction following the 2016 elections. The election of Donald Trump combined with Republican control over Congress cements power in the hands of those who have promised major health care reform related to Medicaid, Medicare, and the Patient Protection and Affordable Care Act (ACA). Medicaid is the major source of financing for health insurance for children in low-income households and their parents; Medicaid is also the secondary source of financing for health insurance, after Medicare, for low-income elderly individuals and low-income individuals with disabilities. Medicaid currently covers 1.9 million North Carolinians and accounts for 17% of total state appropriations. Any changes to Medicaid will have a significant impact on North Carolina [1-3]. What Could Medicaid Reform Look Like? President-elect Trump supports turning Medicaid into a block grant program in order to decrease costs to the federal government and increase states' roles in managing Medicaid [4]. House Speaker Paul Ryan's plan gives states the option of a per-capita allotment or a block grant for Medicaid, which is aimed at encouraging states to innovate, manage care, and utilize Medicaid waiver programs. Per-capita allotment would allocate Medicaid resources to states based on the number of beneficiaries in each programmatic category. Ryan's block grant option provides maximum flexibility in Medicaid design; minimum requirements would remain, such as paying for care for the vulnerable elderly poor and for individuals with disabilities, but other eligibility…


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