Consolidating certain aspects of financing care for some of the poorest older and disabled Americans at the federal level could soften the blow significantly to state budgets, a new analysis shows. Shifting long-term care coverage from Medicaid to Medicare is one of the report’s recommendations.

Moving more of the cost of care for so-called dual-eligibles – the 9 million Americans eligible for both Medicaid and Medicare – from Medicaid to Medicare could save states as much as $47 billion annually, say study authors from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, and researchers at the Urban Institute. A majority of nursing home residents fit under the “dual eligible” label.

Although dual eligibles make up only 18% of the Medicaid population, they account for nearly 50% of all Medicaid medical spending. The analysis can be found at www.kff.org/medicaid/7862.cfm.