The Kaiser Family Foundation has released a brief examining aspects of the national health care reform law affecting dual eligibles.  The authors note that the law offers measures to improve care quality and reduce costs.  The brief suggests that doing so is critical because dual eligibles comprise 15 percent of the Medicaid-covered population but represent 39 percent of Medicaid spending, and comprise 21 percent of the Medicare-covered population but represent 36 percent of Medicare spending.  The authors outline how the law improves care integration, requires improved quality, and increases access to home and community-based long-term services and supports.

From the report:

There are 9 million Medicaid beneficiaries who are “dual eligibles”—low-income seniors and younger persons with disabilities who are enrolled in both the Medicaid and Medicare programs. The Affordable Care Act (ACA) includes a number of provisions aimed at improving care and streamlining service delivery for dually eligible Medicaid and Medicare beneficiaries. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs; they comprise only 15 percent of total Medicaid enrollment yet represent 39 percent of annual Medicaid expenditures. Similarly for Medicare, duals represent 21 percent of Medicare enrollees but 36 percent of Medicare expenditures. Dual eligibles’ care needs are served through both the Medicare and Medicaid programs. Medicare primarily pays for acute and hospital care, and prescription drugs, while Medicaid generally helps to pay for Medicare premiums, cost sharing and long-term care, as well as other non-medical services. 

Full report: Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries (PDF | 300.90 KB)

Kaiser Family Foundation.  (2011).   Affordable Care Act provisions relating to the care of dually eligible Medicare and Medicaid beneficiaries.