The Economics of Medicaid: Assessing the Costs and Consequences

Jason J. Fichtner

2014 mar. · Mercatus Center at George Mason University

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Medicaid, originally considered an afterthought to Medicare, is today the largest health insurance provider in the United States. Under the Affordable Care Act, the Congressional Budget Office projects Medicaid enrollment to increase nearly 30 percent by 2024 and federal spending on the program to double over the next decade. For the states, Medicaid is already the largest single budget item, and its rapid growth threatens to further crowd out other spending priorities.

In this collection of essays published by the Mercatus Center at George Mason University, nine experts discuss the escalating costs and consequences of a program that provides second-class health care at first-class costs. The authors begin with an explanation of Medicaid’s complex state-federal funding structure. Next, they examine how the system’s conflicting incentives discourage both cost savings and efficient care. The final chapters address the pros and cons of the most mainstream Medicaid reform proposals and offer alternative solutions.

This book offers a timely assessment of how Medicaid works, its most problematic components, and how—or if—its current structure can be adequately reformed to provide quality care for those in need at sustainable costs.

Contributors include:
• Joseph Antos, American Enterprise Institute
• Charles Blahous, Mercatus Center at George Mason University
• Darcy Nikol Bryan, MD, practicing physician
• James C. Capretta, Ethics and Public Policy Center
• Robert F. Graboyes, Mercatus Center at George Mason University
• June O’Neill, Baruch College, CUNY
• Nina Owcharenko, Heritage Foundation
• Thomas Miller, American Enterprise Institute