Perspective Examines Challenges Facing Health Care, Medicaid Amid Economic Recession

"Health Care and Medicaid -- Weathering the Recession," New England Journal of Medicine: In the perspective, Diane Rowland -- executive vice president of the Kaiser Family Foundation and executive director of the Foundation's Commission on Medicaid and the Uninsured -- examines how the economic recession has "increasingly constrained" Medicaid as more people seek health coverage through government programs and state revenues decline. Rowland discusses the health care implications of the recession for individuals, providers and governments. She writes, "As this recession has deepened, the need to stabilize coverage and shore up our health safety net as part of our response to the economic crisis has become ever more apparent." Rowland adds, "Medicaid can serve as a platform for broadened coverage of the low-income population, but achieving this goal will require new policies that establish a minimum eligibility threshold for adults (including those without dependent children), promote greater access to primary care and equity in payment rates across payers, provide more automatic countercyclical federal financing during economic downturns, and restructure federal and state responsibilities to ensure that financing for coverage remains secure" (Rowland, NEJM, 3/26).