Cost-Sharing Implementation for Children Among State Medicaid Programs

Mary Mathew, MPH, Paul F. Turcotte II, MPH, Kaitlin H. Koffer Miller, MPH, Lindsay Shea, DrPH, MS

Abstract


Cost containment and quality service delivery through Medicaid programs are a top priority in the United States. In order to curb costs, the Deficit Reduction Act (DRA) of 2005 allowed states to impose cost-sharing, including copays, on previously exempt groups, such as children. Research on the implementation of the DRA among states has been limited. This study surveyed 50 states and the District of Columbia to identify state copay policies for children on Medicaid receiving behavioral health services (a group who was exempt from copays before the DRA). Analysis of state Medicaid policies revealed that Illinois, Wisconsin, and Idaho implemented copays for this group of children. These states had variable policies impacting children with different family income levels, age requirements, and service needs. The findings of this study issue a call for additional research on the impact of these copays on service utilization and actual cost savings observed by states.


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