Medicaid Reform

 VII. Key Issues: Regulation & Reform >> C. Health Reform >> Components of Health Reform >> Public Sector Programs >> Medicaid Reform (Last update: 2.20.17)

Comprehensive Medicaid Reform Proposals

Think Tank/Academic Proposals


  • Medicaid Managed Care Not Working Out for Behavioral-health Patients. “But as Lee and Barton have discovered, a safety net is only as strong as the people holding it. For them, that’s Cardinal Innovations, the largest of seven private organizations known as local management entities (LME) or managed care organizations (MCOs)… But before rushing back to government-managed Medicaid, Gianoli says there is a better option — give Medicaid money directly to patients, instead of managers, doctors or hospitals… ‘If patients were actually using their own money to buy medical care, instead of relying on third-party payers, I don’t think many would buy into the MCO once they knew what it really was,’ Gianoli said, adding that now is a good time to revisit the idea with Congress currently in the process of repealing Obamacare. ‘This would incentivize Medicaid patients to use their medical dollars more expeditiously and would have Medicaid providers competing for those dollars. A much better incentive alignment than capitation or MCOs,’ he said. Christine Kirby, for one, would be on board with Medicaid HSAs. ‘If I had an HSA funded by the state and Medicaid for my son, and I chose his services and interviewed providers, I’m 100 percent confident that I would manage the funds way better than Cardinal,’ said Kirby.” (, 1.18.17)

Guaranteed Income Proposals

Various guaranteed income proposals by libertarian scholars include provisions to handle medical care for poor families.

Incremental Medicaid Reform Proposals

Federal Legislative Proposals

Other Proposals

Impact of Medicaid Reform


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