Medicare and Medicaid News

Publius, Vol. 28, No. 3. (1 January 1998), pp. 161-174

Welfare reform did not usher in comprehensive Medicaid reform, if "reform" is defined as dismantling the basic framework or design of the nations's health-care system for the poor. Instead, it left much of the previous Medicaid system intact. However, welfare reform has contributed to changes in the Medicaid-eligible populations, greater variability and experimentation with state Medicaid initiatives, and greater sate control over Medicaid program decisions. Thus, the welfare-reform movement clarified a major trend in contemporary American politics--the increase in state discretion and flexibility in social welfare policymaking. The states are now at the center of Medicaid decisionmaking, and they are in a key position to determine the future direction of heath-care assistance for the poor in the United States.
Saundra Schneider