Pursuant to a congressional request, GAO provided information on the decline in Medicaid enrollment, focusing on: (1) Medicaid enrollment changes for families and children following welfare reform, as well as associated key federal protections established for Medicaid; and (2) states' welfare-related policies and practices that can influence Medicaid enrollment.
Matter for Congressional Consideration
|To further facilitate families' making the transition from welfare to work and to prevent income-eligible families from being terminated from Medicaid for procedural reasons, Congress should consider revising section 1925 of the Social Security Act. Specifically, Congress may wish to allow states to lessen or eliminate periodic income reporting requirements for families receiving transitional Medicaid coverage, provided that states offer adequate assurances that the benefits are reserved for those who are eligible. Actions in this regard could facilitate uninterrupted health insurance coverage for families that are moving from cash assistance to the workforce.||Legislation has been proposed several times by members of Congress but has not been enacted.|
Recommendations for Executive Action
|Health Care Financing Administration||1. In order to ensure that eligible individuals leaving cash assistance do not lose Medicaid coverage, the Administrator, HCFA, should determine the extent to which transitional Medicaid is reaching the eligible population.|
|Health Care Financing Administration||2. In order to ensure that eligible individuals leaving cash assistance do not lose Medicaid coverage, the Administrator, HCFA, should provide states with guidance or other appropriate technical assistance regarding best approaches for implementing transitional Medicaid in a manner that facilitates the full and appropriate use of this entitlement for eligible beneficiaries.|