By NextBestFitPhase 4: Wave 4: everyone · Step 4.3
Fold Medicaid and CHIP into UHP
Year 4 (dual eligibles and children earlier) · States; UHADiscuss this step
Medicaid's acute-care and LTSS functions move to UHP. States begin paying the maintenance-of-effort amount ($345.7B a year) in place of their Medicaid share. Medicaid managed-care contracts end.
Legal vehicle
Universal Health Act, Titles VIII & IX; SSA Title XIX amended to a residual program for non-medical services.
Who does it
States; UHA
When
Year 4 (dual eligibles and children earlier)
One-time cost
$16.0B
Parallel systems $12.0B and state wind-down grants $4.0B, in the transition table.
In this step
Tasks
6 tasks
Costs & calculations
5 cost items, each with its calculation
Trade-offs
3 pros · 2 cons · 2 trade-offs
Risks
1 risks with mitigations
What changes in the system
5 existing laws, programs, or institutions changed
Other countries
2 comparisons
Cost items
- Federal share of Medicaid$596.7B
- Running legacy Medicaid, Marketplace & Medicare systems in parallel$12.0B
- State Medicaid agency wind-down$4.0B
- Jobs: State Medicaid eligibility & managed-care oversight staff−$1.6B
- Jobs: Marketplace call centers, navigators & enrollment assisters−$0.6B
Steps that depend on this one
None.