Health Care Reform: Potential Difficulties in Determining Eligibility for
Low-Income People (Letter Report, 07/11/94, GAO/HEHS-94-176).

To obtain basic health care, more than 30 million people depended on
Medicare in fiscal year 1992.  Federal and state governments spent
nearly $120 billion to provide services to these people. However,
millions of people with income below the poverty line are not now
covered by Medicaid.  Many of these who are potentially eligible do not
apply and many who apply are denied enrollment and remain uninsured.
Because health care reform may expand coverage to many of the uninsured,
some form of means testing may be required to determine eligibility.
This report identifies the (1) reasons why people who may be potentially
eligible for Medicaid are not being enrolled, (2) incentives hospitals
have to facilitate enrollment of their patients in Medicaid, and (3)
implications for eligibility determinations if health care reform is
enacted.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  HEHS-94-176
     TITLE:  Health Care Reform: Potential Difficulties in Determining 
             Eligibility for Low-Income People
      DATE:  07/11/94
   SUBJECT:  Claims processing
             Eligibility determinations
             Medical expense claims
             Hospitals
             Hospital care services
             Health care costs
             Eligibility criteria
             Disadvantaged persons
             Public assistance programs
IDENTIFIER:  Medicaid Program
             Aid to Families with Dependent Children Program
             AFDC
             Supplemental Security Income Program
             Georgia
             Illinois
             Massachusetts
             Clinton Health Care Plan
             National Health Care Reform Initiative
             American Health Security Act of 1993
             
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