Refocusing Responsibility For Dual Eligibles: Why Medicare Should Take The Lead

September 30, 2011 An October 2011 report by the Robert Wood Johnson Foundation and the Urban Institute argues that Medicare, not state Medicaid plans, have primary responsibility for setting policies regarding individuals eligible for both Medicare and Medicaid—dual eligibles. The authors based their argument on the language in the Patient Protection and Affordable Care Act of 2010, which directs Medicare to improve care for all beneficiaries. They noted that state plans for demonstration projects blending Medicare and Medicaid funding streams and services for dual eligibles may put the individuals at-risk for poor health outcomes because states lack experiencing . . .