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

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).