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 ************************************************************************ We regret that the full text of this item is presently unavailable. See the GAO FAQ - Section 2.0 for printed copy ordering information. The FAQ is automatically retrieved with all WAIS search results or can be obtained by sending e-mail to: [email protected]