Medicare,Medicaid,andPeopleWithDisability.pdfVIP

Medicare, Medicaid, and People With Disability Robert J. Master, M.D., and Carol Taniguchi, M.P.H. INTRODUCTION WHY MEDICARE AND MEDICAID? When Medicare was amended in 1973, expanding entitlement to people with disability, it played a key role in promoting independence and autonomy and enhancing health care for this population, which traditionally had been underserved. Medicare recipients with disability have been the fastest growing Medicare-entitled popula- tion, and Medicare, along with Medicaid, has had to adjust to meet the needs of this ever-changing group. Both programs must continue to evolve to develop services designed specifically for people with disability. Today, more than 6 million Americans under 65 years of age with severe disabilities receive a vast array of medical, hospi- tal, support, rehabilitative, residential, and long-term care (LTC) services through Medicare and Medicaid. These programs have contributed to the sea change in the national attitude toward people with disabilities and promoted the independence and autonomy of millions through the funding of services that were non-existent and perhaps even inconceivable 30 years ago. In this article, we describe the historic imperative for publicly financed insurance programs for people with disabilities, the characteristics of Medicare- and Medicaideligible recipients with disability, the array of services now available to them through these two programs, and lastly, obstacles to and opportunities for continued reform as they present themselves today. Robert J. Master is President and Medical Director of Community Medical Alliance and Associate Professor of Health Services at the Boston University School of Public Health. Carol Taniguchi is with Community Medical Alliance. The opinions expressed are those of the authors and do not necessarily reflect those of Community Medical Alliance, Boston University, or the Health Care Financing Administration. Thirty years ago, people with severe disabilit