Rationing Rights: Administrative Burden in Medicaid Long-Term Care Programs.

Context: States use Medicaid waivers to provide supports for disabled people in communities rather than in institutions. Because waivers are not entitlements, those deemed eligible are not guaranteed these supports. How do states, in practice, use bureaucratic procedures to ration this "conditional"...

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Publicado en:Journal of Health Politics, Policy & Law Vol. 50; no. 2; pp. 223 - 252
Autores principales: Herd, Pamela, Johnson, Rebecca A.
Formato: Artículo
Publicado: Duke University Press Apr2025
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2025
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      pub: Duke University Press
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        atl: Rationing Rights: Administrative Burden in Medicaid Long-Term Care Programs.
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        au:
          Herd, Pamela
          Johnson, Rebecca A.
        affil:
          University of Michigan
          Georgetown University
      su:
        United States
        Medicaid law
        Health services accessibility
        Community health services
        Managed care programs
        State governments
        Human rights
        Associations, institutions, etc.
        Needs assessment
        Health care rationing
        People with disabilities
        Medical care costs
        Long-term health care
        Descriptive statistics
        Eligibility (Social aspects)
      sug:
        subj:
          Medicaid law
          Health services accessibility
          Community health services
          Managed care programs
          State governments
          Human rights
          Associations, institutions, etc.
          Needs assessment
          Health care rationing
          People with disabilities
          Medical care costs
          United States
          Other Similar Organizations (except Business, Professional, Labor, and Political Organizations)
          Community health centres
          All Other Outpatient Care Centers
          Residential Mental Health and Substance Abuse Facilities
          Other Individual and Family Services
          Other local, municipal and regional public administration
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Long-term health care
          Descriptive statistics
          Eligibility (Social aspects)
      keyword:
        disability
        inequality
        long-term care
        Medicaid
        disability
        inequality
        long-term care
        Medicaid
      ab: Context: States use Medicaid waivers to provide supports for disabled people in communities rather than in institutions. Because waivers are not entitlements, those deemed eligible are not guaranteed these supports. How do states, in practice, use bureaucratic procedures to ration this "conditional" right? Methods: Drawing on primary and secondary data, the authors analyze waiver programs and document state administrative procedures that indirectly and directly ration access. Findings: Burdens indirectly limit disabled people's access to Medicaid home- and community-based services via a complex array of waiver programs that exacerbate costs associated with gaining eligibility. In addition, burdens directly limit access via wait lists and prioritization among the eligible. There is also evidence that states strategically deploy opaqueness to provide political cover for unpopular wait lists. The overall process is opaque, confusing, and time intensive, with burdens falling hardest on marginalized groups. Conclusions: Administrative burdens impede disabled people's efforts to exercise their right to live in the community as afforded to them under the American with Disabilities Act. The opaqueness and associated burdens with waiver programs are a way to conceal these burdens, thereby demonstrating how burdens "neatly carry out the 'how' in the production of inequality, while concealing... the why" (Ray, Herd, and Moynihan 2023: 139).
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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