The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.

The federal government is the largest employer in the United States, and the Federal Employees Health Benefits Program (FEHBP) is the largest employer-sponsored health insurance program. FEHBP covers about 8 million individuals, providing an estimated $43 billion annually in health care benefits. The participation rate among eligible enrollees is about 90% (85% of eligible individuals enrol in FEHBP as the primary policy holder, and another 5% are covered as a family member). This book examines the essential elements and legislative history of FEHBP with a focus on available health insurance options; laws affecting FEHBP; and health benefits for Members of Congress.