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 Adolescent Health Care – Medicaid, Managed Care, and Health Care Reform: Lessons from the 1990s
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From the Preface
In 1995, the National Center for Youth Law and the National Health Law Program initiated a study of Medicaid, managed care, and health care reform issues with importance for adolescents’ access to health care.
The study was conducted from 1995 through mid-1999 with the support of the Carnegie Corporation of New York.
The study included a review of the literature on the health status and health care needs of adolescents; detailed legal research and analysis of the laws pertaining to Medicaid, managed care, and health care reform as they affect adolescents; an analysis of Medicaid managed care contracts and requests for proposals; an analysis of Medicaid Section 1115 demonstration waivers; a survey of adolescent health care professionals; two meetings of adolescent health experts; and case studies of several states that included both key informant interviews and analysis of state laws.
The data and analysis from that study have informed this report. Findings from the 1990s revealed important implications of laws and policies for the delivery of health services to adolescents and adolescents’ access to care. Both innovations and obstacles were identified and some of each are reported here. Now, nearly a decade later, the policy climate is different from that which prevailed when we began our study.
At the end of the 1990s and in the years immediately after 2000, the policy climate shifted at the federal and state levels, generally becoming less hospitable to expansion of health care coverage, benefits, and access for low income and vulnerable populations, including adolescents.
Nevertheless, ongoing concern is focused on the high percentage of the U.S. population, including adolescents, that is uninsured or underinsured, with considerable variation views of the best way to address the problem.
Support for the preparation of this report was provided by the Carnegie Corporation of New York.
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