View Research by Author - Janemarie Mulvey

Publications

This paper examines two factors that are especially important in determining the economic status of older Americans—their expenditures on health and their asset holdings. The authors take a pragmatic approach to incorporating these two factors into measures of economic well-being and poverty in the elderly. They apply several alternative measures to national population data, recalculating poverty rates for people aged 65 and over.

Elderly Americans are protected by three major entitlements: Social Security (cash benefits), Medicare (health benefits for all elderly), and Medicaid (additional health benefits for low-income elderly). The range of proposals to change these programs is unprecedented. This book does not question the need to make cuts. Rather, it argues that looking for cuts first is the wrong way to go. We should look first for needed improvements in responsiveness and efficiency in all three programs, then add up how much these changes would save and decide how best to use the savings. Pursuing this strategy, the authors identify many changes worth consideration.

This paper explores enrollment and cost estimates for providing Medicaid coverage to Alaskan children, pregnant women, and nonpregnant adults. It provides enrollment and expenditure estimates of implementing two Medicaid policy options using five different income eligibility criteria. Included are a description of health care reform options under Medicaid; health insurance coverage and health care expenditures under the current system; characteristics of the eligible population; and enrollment and expenditure estimates for selected expansion options. The report concludes with a future projection of expenditures and a discussion of who will pay for the cost of reform.

For this study, data from the 1987 National Medical Expenditure Survey (NMES) were trended forward to 1994 using actual and projected health expenditure data from a variety of sources. One of the unique contributions of this report is its use of individual record analysis to update and calculate averages from the NMES data. This way, each person's estimated share counts equally so that when averages are calculated they are more representative of the typical individual and not skewed by disproportionately high incomes or very large expenditures. The analysis also includes 1994 data on out-of-pocket health costs for those under age 65 for comparison.

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