Medicaid and Health Safety Net Reform

To transform Medicaid and the safety net to improve the well-being of the recipients and ensure that it is accountable to the taxpayers.

• The purpose of a health care safety net is articulated in Medicaid’s statutory charge: “Furnish rehabilitation and other services to help such families and individuals attain or retain capability for independence or self-care.” 42 USC 1396
• Medicaid delivers poor results, failing both those who rely on the program and taxpayers.
• Personal empowerment is essential to achieving fulfillment and prosperity as well as the best program outcomes.
• Overall well-being encompasses much more than medical care and is, in large part, a function of family, friends, community, work, and faith or sense of purpose.
• Medicaid’s current financial structure, with an open-ended federal reimbursement of state expenditures, leads to significant improper and inappropriate spending in the program that disproportionately benefits special interests rather than the intended recipients.

Goal 1: Accountable and Efficient Program

• Ensure that eligible recipients receive the most efficient services in the right setting and at the right time.
• Use proper incentives to maximize actual value for patients from public spending.
• Develop appropriate standards to assess the program’s outcomes.
• Realign incentives and reform financing so both the federal government and states are accountable for results and concerned about the value of the programs.

Goal 2: Improved Health and Well-being of Patients

• Give patients opportunities to choose holistic, individualized health care options.
• Empower recipients to improve health outcomes through proactive, healthy behavior, social and community engagement, and smart interactions with the health care system.
• Consider the overall impact of the variety of social welfare programs on recipients and their incentives to lead the most productive and meaningful lives.