The Balanced Budget Act (BBA) of 1997 allowed states to limit how much their Medicaid programs contributed toward the Medicare cost-sharing liability of dually eligible beneficiaries. Policymakers have grown concerned that such limitations may affect access to care for these beneficiaries. We used a quasi-experimental design to analyze changes in access from 1996 to 1998, using Medicare and Medicaid data from nine states. Cost-sharing payments fell in six of the nine states following the BBA, and access to outpatient physician visits for dually eligible beneficiaries was reduced relative to non-dually eligible beneficiaries in those states.
State payment limitations on Medicare cost-sharing: Impact on dually eligible beneficiaries
Mitchell, J., & Haber, S. (2004). State payment limitations on Medicare cost-sharing: Impact on dually eligible beneficiaries. Inquiry, 41(4), 391-400.