Health Reform, Year Seven: Observations About Medicaid Managed Care

policymakers have reformed State medical assistance programs and, in the process, have grappled with goals of both containing program costs and expanding health insur ance coverage to the uninsured. Currently, nearly one-quarter of all States have imple mented health care reform demonstrations, and this article summarizes trends seen since health care reform began in the 1990s. As well as noting the accomplish ments of health care reform through the use of Medicaid managed care, the article spec ulates, based on recent evidence, about new directions health care reform may take in the future