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
How other countries handled this same piece of implementation, what happened, and what it means for this plan.
Side by side
| Country | Approach | Result | Lesson for this plan |
|---|---|---|---|
| This plan (U.S.) | 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. | ||
| Netherlands | Abolished the public sickness-fund scheme (ZFW) in 2006; low-income help moved to the tax authority as an income-related health allowance (zorgtoeslag). | One scheme for everyone; subsidies administered through taxes. | Means-tested programs can be folded into a universal one, with low-income help moved to the tax system. |
| South Korea | Merged 300+ insurance societies into one National Health Insurance Service in 2000. | Administrative savings; unified benefits. | Consolidating many payers into one is feasible. |
Netherlands
- What they did
- Abolished the public sickness-fund scheme (ZFW) in 2006; low-income help moved to the tax authority as an income-related health allowance (zorgtoeslag).
- What happened
- One scheme for everyone; subsidies administered through taxes.
- Lesson for this plan
- Means-tested programs can be folded into a universal one, with low-income help moved to the tax system.
South Korea
- What they did
- Merged 300+ insurance societies into one National Health Insurance Service in 2000.
- What happened
- Administrative savings; unified benefits.
- Lesson for this plan
- Consolidating many payers into one is feasible.