Fundamentals Briefing

Health Policy Essentials: The Fundamentals of Medicare, Medicaid, and CHIP
February 11, 2011

Managers

Sally Coberly, PhD, Laura A. Dummit & Kathryn Linehan

Summary

Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) enrolled over 100 million people in 2010. Federal outlays for these programs totaled over $730 billion. Medicare and Medicaid program spending (excluding beneficiary out-of pocket spending) was 35 percent of total national health spending in 2009. This briefing covered key aspects of each program including:

  • Who is eligible
  • What benefits are covered
  • How the programs operate
  • How services are delivered (fee-for-service, managed care, etc.)
  • How provider payments are determined
  • How the programs are financed, and
  • Recent trends in program spending.

Expert speakers focused primarily on how the programs operate today, but also addressed the changes that the Patient Protection and Affordable Care Act of 2010 made to eligibility, benefits, payment, and other program elements.

Speakers

James Hahn, PhD, Health Economist, Congressional Research Service, Library of Congress; Chris L. Peterson, MPP, Director of Eligibility, Enrollment, and Benefits, Medicaid and CHIP Access and Payment Advisory Commission

Slides from the presentations by Dr. Hahn and Mr. Peterson are available for download.

Related Materials

For more information on health reform-specific issues, see "Focus on Reform: Medicaid Coverage Expansions" (Forum Session, May 7, 2010) and other meetings in our Health Reform series.

In 2015, a new version of the Forum's Health Policy Essentials series was conducted; please see its briefing book here.

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