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  1. Rosenbaum, Sara JD


Abstract: Medicaid plays an enormously important role in ambulatory care financing, both primary and specialized, for patients with routine health needs, as well as individuals with chronic illness and disability. Nearly all Medicaid beneficiaries receive the vast bulk of their health care in ambulatory settings. Medicaid plays a critical role for low-income persons, including children, pregnant women and families, and elderly and disabled Medicare beneficiaries. The Bush administration's proposal to subject federal Medicaid spending to annual aggregate limits could be expected to have especially severe effects on states' capacity to support ambulatory services and achieve innovations in community-based care.


IT IS EASY to overlook Medicaid's role in financing ambulatory health care. Medicaid is the nation's single largest source of long term institutional health care financing, and its importance to the U.S. health system in a long term care context is a principal policy driver at both the federal and state levels of government. Indeed, much of the current national debate over Medicaid reform focuses on the program costs related to long term and care for individuals with chronic and serious health problems (Iglehart, 2003).


But Medicaid's ambulatory care role is enormously important. The interaction between Medicaid and the vast array of services, benefits, and procedures furnished in an ambulatory setting is no less significant than its interaction with health care institutions. This article examines Medicaid's role in ambulatory care and considers the current Medicaid national policy debate in this context. The figures presented in this article come from the Kaiser Commission on Medicaid and the Uninsured, a special project of the Henry J. Kaiser Foundation, dedicated to research and analysis related to Medicaid and health coverage for low-income populations generally.