The Future of Medicaid

Main Article Content

Arnold Birenbaum


Medicaid, block grant, long-term care


Medicaid, the US federal-state financed program that assists people to gain access to health services when they cannot afford them, is in peril.  Some of the recently defeated proposals to change financing of the program, the shift to managed care, and massive state deficits all threaten to limit optional and Home- and Community-Based Waiver Services to people with long-term care requirements.  This policy research paper will explore some current myths about Medicaid, what states are doing to reduce Medicaid expenditures, and propose 10 principles and observations that should shape a response from the disability community to efforts to shrink Medicaid.

Abstract 147 | PDF Downloads 36 Word Downloads 33 Text Downloads 45


Associated Press. (2003, September 26). Number of people living in poverty in U.S. increases again. New York Times. Retrieved June 2nd, 2004 from

Freudenheim, M. (2003, February 19). Some Concerns Thrive on Medicaid. New York Times, B1.

Halstead, T. (2003, January 30). To guarantee universal coverage, require it. New York Times, A27.

Just, T. S. (2003). Disentitlement: The threats facing our public health-care programs and a rights-based response. New York: Oxford University Press.

Krauss, M. W., Gulley, S., Sciegaj, M., & Wells, N. (2003). Access to specialty medical care for children with mental retardation, autism, and other special health care needs. Mental Retardation, 41, 329-339.

Perez-Pena, R. (2003, October 14). Report faults Medicaid managed care plan. The New York Times. Retrieved October 15th, 2003 from http:///

Public Law 97-35, section 2176. (1981). United States Codes.

Policy Brief. (2003). The importance of public insurance/Medicaid coverage for children with special health care needs. Retrieved October 30th, 2003 from .

Roberts, B. S., & Considine, B. G. (1997). Public policy advocacy. In H. M. Wallace, R. F. Biehl, J. C. MacQueen, & J. A. Blackman (Eds.), Mosby's resource guide to children with disabilities and chronic illness (pp. 162-171). St. Louis, MO: Mosby-Year Book.

Saeed, K., & Wallace, J. (2003, November 2). Health care costs burden taxpayers. The Journal News, A14.

Thompson, J. W., Ryan, K. W., Pinidiya, S. D., & Bost, J. E. (2003). Quality of care of children in commercial and Medicaid managed care. Journal of the American Medical Association, 290, 1486-1493.