Medicare and Medicaid Services Online: Government Initiatives Narrowing Online Access Inequalities

Medicare and Medicaid Services Online: Government Initiatives Narrowing Online Access Inequalities

Mary Schmeida (Kent State University, USA) and Ramona McNeal (University of Northern Iowa, USA)
DOI: 10.4018/978-1-4666-8358-7.ch032
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Abstract

Government initiatives in the United States have been passed in an effort to increase citizen usage of e-government programs. One such service is the availability of online health insurance information. However, not all demographic groups have been equally able to access these services, primarily the poor and rural American. As more legislation is passed, including the advancement of broadband services to remote areas, infrastructure barriers are being removed, opening access to Medicare and Medicaid websites for these vulnerable groups. The purpose of this chapter is to analyze factors predicting the impact of recent government actions on citizen access to health insurance information online. This topic is explored using multivariate regression analysis and individual level data from the Internet and American Life Project. The findings suggest that healthcare needs and quality of Internet access may be playing a more important role in health insurance information services than other factors.
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Background

The U.S. federal and state-local governments have adopted some form of electronic government practice to increase Medicare and Medicaid enrollment by broadening access to information and services through advanced communication technology such as the Internet. To improve access to these public health insurance programs, the federal government has established Web-based information on Medicare eligibility criteria, enrollment guidelines, public health service centers, among other information. States have also made considerable progress in Website technical development (West, 2005) with each of the 50 states providing residents with Medicaid online service information. These changes in government practices are part of a larger trend in information provision and management in the public sector. Starting with the Clinton Administration, all levels (federal, state and local) began adopting practices of electronic or e-government, which “refer to the delivery of information and services via the Internet or other digital means” (West, 2004, p. 2).

E-government policies were adopted under the Clinton Administration with hopes that the Internet could be used to deliver goods and services in a way that would reduce government cost and increase efficiency. These same goals helped motivate the passage of the E-government Act 2002, signed into law by President George W. Bush on December 17, 2002. Despite the promises of e-government, there are factors that limited the potential for government savings through delivery of government services and information online. One such issue is the “two-systems” problem. Until the government can bring all citizens online, it will need to deliver services and information in two ways. The first is the traditional methods including face-to-face, phone and mail and second through electronic means. This will limit the potential for cost savings (Fountain, 2001).

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