The 1950 amendments are substantial in scope and, when taken together with the changes made to the old-age and survivors insurance program, should have a profound effect on the state-federal assistance programs. State and federal assistance agencies will need time to work with these amendments before their exact effect can be assayed and future trends determined and changes planned. Several respects in which the state-federal assistance programs are deficient and in need of improvement are now well known. Assistance programs financed from state and federal funds still fall short of the objective of being available to any needy person. The new program for the permanently and totally disabled will meet some of the needs of persons previously not covered by a state-federal program. There are many disabled persons, however, who are equally in need but who are not permanently and totally disabled and who will not be aided under the new program. These individuals will be dependent upon state and local general assistance programs. In a number of states these programs are far from adequate and in some areas nonexistent. We also know that the direct payments for medical care, potentially, can be an important part of the assistance program. This plan cannot achieve its potential, however, without some additional money from the federal government either in the form of a separate provision in the formula governing the federal share for medical expenditures, or in the form of an increased average maximum on the assistance payments. Without such provisions, the usefulness of the new amendment to make direct payments for medical care will be limited. To the extent that states divert money from supplying maintenance needs to paying for medical care, the new amendment might actually reduce the amount of money available for meeting maintenance needs. With additional money, the medical care amendment can do a great deal to meet medical costs not now met by other programs such as health or rehabilitation. In this statement, I have attempted to analyze the new amendments and to evaluate their effect on the public assistance programs. Although the new amendments leave some deficiencies uncorrected, they have advanced the programs considerably and should result in a considerably improved state-federal plan for meeting the assistance needs of people.
Medical Care for Public Assistance Recipients