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De Facto Disentitlement in an Information Economy: Enrollment Issues in Medicaid Managed Care
Author(s) -
LÓPEZ LESLIE
Publication year - 2005
Publication title -
medical anthropology quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.855
H-Index - 55
eISSN - 1548-1387
pISSN - 0745-5194
DOI - 10.1525/maq.2005.19.1.026
Subject(s) - de facto , medicaid , welfare system , managed care , dehumanization , state (computer science) , welfare , business , health care , medicaid managed care , health insurance , economic growth , political science , economics , law , algorithm , computer science
This article discusses enrollment issues in New Mexico's Medicaid managed care (MMC) system and seeks to illuminate reasons for persistent problems reported by workers and clients. It argues that between 1997 and 2000, the MMC and welfare reforms raised enrollment barriers by complicating and dehumanizing the system, thus “technically disenfranchising” workers and clients. Specifically, the new system increased the need for professional, in‐person enrollment assistance precisely when the state decreased its provision of it. Some aspects of the State Child Health Insurance Program (SCHIP) reforms indirectly aggravated those same problems, and though they also significantly lowered barriers in some areas, overall the new system was plagued with preexisting barriers as well as new, unmet needs that produced “de facto disentitlement” to health services.