Restructuring Approaches Leave Many Questions

HEHS-95-103: Published: Apr 4, 1995. Publicly Released: Apr 4, 1995.

Additional Materials:


Office of Public Affairs
(202) 512-4800

Pursuant to a congressional request, GAO provided information on various proposals for restructuring the Medicaid Program, focusing on the: (1) different restructuring approaches and their implications for federal-state financing and program administration; and (2) need to establish a reserve fund to offset state tax losses and increased enrollments.

GAO found that: (1) using block grants to fund state Medicaid programs would increase states' control over federal expenditures and administrative flexibility, which could result in increased operational efficiency and effectiveness; (2) states may increase the risk of not being able to control Medicaid program spending if they reduce their Medicaid contributions; (3) block grant and cap proposals have not addressed how much administrative flexibility states would receive; (4) federalizing the Medicaid program would reduce program inequities and administrative costs, but the federal government would face difficulties in meeting localities' individual needs and operating conditions; (5) the impact of splitting Medicaid into long-term and acute-primary care programs would depend on how the split is made and how responsibilities are distributed between federal and state governments; (6) there has been little quantitative analysis on the potential effects of restructuring Medicaid on financing and administrative functions; and (7) states' Medicaid spending is sensitive to economic conditions and a reserve fund could be one way to assist states during economic downturns if strict limits are placed on federal contributions.

Jan 17, 2018

Jan 16, 2018

Jan 8, 2018

Dec 14, 2017

Dec 5, 2017

Nov 29, 2017

Nov 15, 2017

Looking for more? Browse all our products here