Medicaid in Times of Crisis (GAO-21-343SP)
Summary
A GAO capsule publication, GAO-21-343SP, dated February 2021, on Medicaid in times of crisis. It describes Medicaid as the federal-state health care financing program serving over 70 million Americans of all ages. It explains that during pandemics, economic recessions, natural disasters and other crises, states have enrolled affected individuals, such as those evacuating their residences, and the federal government has waived program restrictions, for example to expand telehealth services. It notes that legislation has also provided additional funding and coverage in response to various crises.
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Full text
February 2021
Medicaid is the federal-state health
care financing program serving over 70
million Americans of all ages, often with
complex conditions. These Americans
MEDICAID IN are often the most vulnerable when
crises hit. Medicaid has been used to
increase funding to states and provide
TIMES OF CRISIS services to those affected.
IN TIMES OF CRISIS... Figure 1: Examples of State and Federal Use of Medicaid during Times of Crisis
When pandemics, economic
recessions, natural disasters, and
other crises occur, states and the
federal government initiate efforts
to mitigate damage and protect
vulnerable groups. Some of these
efforts have included using Medicaid
to ensure eligible individuals continue
to have access to essential health
services.
For example, states have enrolled
individuals into Medicaid who have
been affected by a crisis, such as
those evacuating their residences
due to natural disasters; and the
federal government has waived
program restrictions to allow states
more flexibility, such as expanding
telehealth services when in-person
visits were not reasonable. Legislation
has also provided additional funding
and coverage in response to various
crises.
This capsule pulls from a number
of GAO reports to examine how the
federal government and states have
used Medicaid in times of crises.
GAO-21-343SP Medicaid in Times of Crisis
Each crisis may have unique circumstances and require different approaches for POLICY QUESTIONS
using Medicaid. To the right are the types of questions and considerations that can
be used to assess how—and whether—Medicaid can help. ▶ How—and under what
circumstances—should Medicaid be
Figure 2: Examples of National Health Crises That Occurred in the Past 15 Years used to aid individuals during times
and Corresponding GAO Reports of crisis, and how can it be done
efficiently and effectively?
▶ How can spending flexibility be
increased during times of crisis
while continuing to manage risks of
GAO-07-67 Medicaid improper payments, which
totaled over $85 billion in 2020?
POLICY CONSIDERATIONS
▶ Improved federal oversight
during a crisis could help ensure
GAO-12-38 that beneficiaries are receiving
appropriate care.
▶ Medicaid serves groups of people
with very different health needs, so
states may need an array of tools to
ensure beneficiaries are provided
for during different types of crises.
GAO-16-833
GAO-20-233
▶ Medicaid is one of the largest
components of states’ budgets, and
states’ ability to accept additional
federal funds may depend on any
requirements for participation
and their possible impact on state
GAO-21-265 resources.
GAO-21-191
GAO-20-625 GAO RECOMMENDATION
During recessions, GAO has
recommended that Congress consider
enacting automatic increases in
federal Medicaid spending based on
each states’ increased unemployment
and decreased revenues.
Implementing this automatic,
temporary change would increase
federal Medicaid support in a more
timely and targeted fashion.
GAO SUPPORT
The Government Accountability Office, the audit, evaluation, and investigative This document is based on GAO audit products and is subject to update. For
arm of Congress, exists to support Congress in meeting its constitutional more information about this Capsule, contact:
responsibilities and to help improve the performance and accountability of the
federal government for the American people. Carolyn L. Yocom, Director, Health Care, yocomc@gao.gov
Connect with GAO on Facebook, Flickr, Twitter, and YouTube. Subscribe to our Staff Acknowledgments Susan Barnidge (Assistant Director), Robin S. Burke,
RSS Feeds or Email Updates. Listen to our Podcasts. Visit GAO on the web at Dhara Patel, Cathy Hamann, and Ethiene Salgado-Rodriguez.
https://www.gao.gov.
Source: Rawpixel.com/stock.adobe.com (cover photo).
Orice Williams Brown, Managing Director, Congressional Relations,
WilliamsO@gao.gov, (202) 512-4400
Chuck Young, Managing Director, Public Affairs,
youngc1@gao.gov, (202) 512-4800
U.S. Government Accountability Office,
441 G Street NW, Washington, DC 20548
GAO-21-343SP Medicaid in Times of Crisis
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