HIRP and NASHP / Project Report

Administering a Medicaid + Tax Credits Initiative
February 28, 2007


Lynn Etheredge, Judith D. Moore, Sonya Schwartz & Alan Weil


For the past several years, there has been interest in proposals that would cover the uninsured through a combination of new federal health insurance tax credits and expansion of state Medicaid and State Children’s Health Insurance (SCHIP) programs. This report presents the results of a project, conducted jointly by the Health Insurance Reform Project and the National Academy for State Health Policy, that focused on the issues and problems of administering such initiatives.

The study was undertaken because implementing a nationwide “Medicaid + Tax Credits” initiative to cover 47 million uninsured persons, in more than 50 federal-state programs, would pose unprecedented, large, and complex administrative challenges for both the public and private sectors. The project convened a series of three working meetings with federal, state, and private sector experts who would likely be involved in implementing a Medicaid + Tax Credits initiative in order to identify key administrative problems and to discuss options for how to handle them.

This document includes four main sections: an Overview of Major Administrative Tasks, a Summary of Suggestions for Administrative Efficiency, a Discussion of Major Administrative Issues and Options, and an Appendix. The Overview, Summary, and Discussion present different levels of detail for different readers, and the Appendix presents the agendas of the three meetings.

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