Medicaid/CHIP - Health Policy, Public Opinion & Research

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A Mid-Year State Medicaid Budget Update for FY 2012 & A Look Forward to FY 2013
This update finds that, while most states are on track with their Medicaid budget and enrollment trends for FY 2012, some states are trying to close budget gaps by making mid-year revisions. The report, based on structured discussions with leading Medicaid directors, builds on findings from the most recent comprehensive 50-state Medicaid budget survey.

Survey, Briefing Examine the Latest Data On Medicaid And CHIP Enrollment and Eligibility Policies in the 50 States and D.C.
A 50-state survey finds that despite state fiscal challenges, Medicaid and CHIP eligibility remained stable during 2011, and 29 states made program improvements, often using technology to boost efficiency. Related reports examine successful efforts to cover children in four states and identify potential performance measures for states’ eligibility and enrollment systems under health reform.

Key Resources on Medicaid: How It Works, How It's Financed and Whom It Serves
Several KCMU resources provide a basic overview of the Medicaid program, including the chartpack Top 5 Things To Know About Medicaid, and the papers Medicaid Matters: Understanding Medicaid's Role in Our Health Care System and Faces of Medicaid. Medicaid Financing Issues: Provider Taxes reviews the use of provider taxes as a mechanism for financing the state share of Medicaid spending. Finally, a study analyzes the projected state-by-state impact on Medicaid enrollment and spending of converting the program to a block grant financing under the House Budget Plan. An issue brief looks at the balance between federal standards and state options in Medicaid programs. And a brief summarizes some of the Medicaid proposals that officials in Washington and elsewhere have considered as part of continuing efforts to reduce the federal deficit. Another looks at Medicaid Enrollment and Expenditures by Federal Core Requirements and State Options.

Medicaid in Health Reform
The Foundation has prepared a summary of key Medicaid and Children’s Health Insurance Program provisions in the health reform law, as well as a timeline of important implementation dates and an analysis of potential state-by-state impacts on Medicaid enrollment and spending. Other briefs examine the opportunity for optimizing Medicaid’s reach, answer key questions about Medicaid’s role in state/federal budgets and health reform, and analyze the potential costs and savings to states, and examine proposed Medicaid eligibility, enrollment and coordination regulations under health reform. A tutorial summarizes the Medicaid changes in the law. An issue brief examines performance measures for eligibility and enrollment systems, and an analysis looks at the implications of health reform for Medicaid's role in financing diabetes care.

Resources on Dual Eligibles
A fact sheet explains Medicaid’s role for the nearly 9 million people who qualify for both Medicaid and Medicare, among the sickest and poorest individuals covered by either program. We also have short profiles of four individuals who qualify for both programs. An issue brief discusses the health reform law provisions designed to help this population. A policy brief summarizes 15 states' preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. Another brief provides an update on financial alignment models for dual eligibles based on information in the CMS July 2011 State Medicaid Director letter and the responding states' letters of intent.

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Medicaid and Managed Care: Key Data, Trends, and Issues -- February 2012

State Fiscal Conditions & Medicaid -- February 2012

State Adoption of Coverage and Enrollment Options in The Children's Health Insurance Reauthorization Act of 2009 -- February 2012

A Guide to the Supreme Court's Review of the 2010 Health Care Reform Law -- February 2012

Performing Under Pressure: Annual Findings of a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP, 2011-2012 -- January 2012

Briefing, Survey Examine 2012 Data From 50-State Survey of Medicaid and CHIP Eligibility and Enrollment Policies -- January 2012

Medicaid Enrollment and Expenditures by Federal Core Requirements and State Options -- January 2012

Medicaid's Role for Women Across the Lifespan: Current Issues and the Impact of the Affordable Care Act -- January 2012

Pulling it Together: 2012: The ACA, and More -- January 2012

Performance Measurement Under Health Reform: Proposed Measures For Eligibility and Enrollment Systems and Key Issues and Trade-offs to Consider -- December 2011

This brief provides a snapshot of the Medicaid program's use of managed care to deliver services to beneficiaries.

This fact sheet summarizes the relationship of Medicaid with state budgets and discusses the current fiscal situation in the states and how it is affecting Medicaid programs.

This fact sheet provides an overview of new coverage options, enrollment tools and incentives provided by the Children's Health Insurance Reauthorization Act of 2009 and state adoption of those options to date.

This brief examines the pending Supreme Court case challenging the 2010 Affordable Care Act, including the key constitutional questions issues and the parties' legal arguments.

The annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost sharing practices, found that, despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children’s Health Insurance Programs during 2011.

Report and other materials from the Jan. 18, 2012 public briefing on KCMU's annual 50-state survey of Medicaid and CHIP Eligibility and Enrollment Policies.

This analysis uses 2007 data to examine the proportion of Medicaid enrollment and spending attributable to state expansion enrollees versus federal core enrollees and presents estimates of spending on mandatory versus optional health benefits across all enrollee types.

This issue brief provides an overview of the Medicaid program and its role in providing health and long-term care coverage for low-income women.

In his latest column, Kaiser Family Foundation President Drew Altman looks ahead at the wide range of health policy issues and marketplace changes that will be in play inside and outside the Beltway in 2012.

This brief seeks to inform the development of performance measures for states' eligibility and enrollment systems under health reform by presenting a list of potential performance measures and identifying key issues and tradeoffs to consider in selecting and developing measures.

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Medicaid/CHIP

Medicaid is the nation's public health insurance program for low-income Americans, financing health and long term care services for more than 55 million individuals. The program provides access to affordable and comprehensive health care for children and adults in low-income working families and for the elderly and disabled who often rely on the program to fill in critical gaps in their Medicare coverage. Although three quarters of Medicaid's enrollees are adults or children, the elderly and disabled account for 70% of the program's expenditures. Financed and operated jointly by the states and federal government, Medicaid accounts for roughly one sixth of the nation’s health care spending and almost half of all spending on long term care. As the largest source of federal support to the states, Medicaid is also a major engine in state economies, supporting millions of jobs across the country. Its guarantee of open-ended federal financing that matches state spending enables states to respond to losses of private health insurance attributable to unemployment and rising health insurance premiums, increases in health care costs, emergencies and disasters, and an aging society.

The State Children's Health Insurance Program (CHIP) was enacted in 1997 to provide a capped amount of federal matching funds to states for coverage of children and some parents with incomes too high to qualify for Medicaid, but for whom private health insurance was either unavailable or unaffordable. Covering roughly four million children, CHIP has played an important role in reducing the number of uninsured children in America.

This section provides data and information on the Medicaid and CHIP programs with a focus on the populations they serve. Analyses of proposals to restructure these programs, data from surveys, studies of the impact of recent programmatic changes on beneficiaries, and basic information on how the programs operate and are administered can all be found here. These materials can help to inform discussions of reform proposals and efforts to improve and maintain health coverage and financing for the low-income disabled and elderly populations, families, and children who are left out of our country’s fragmented, employer-based health care system.

The Kaiser Commission on Medicaid and the Uninsured is the main source for the Foundation's work related to the Medicaid and CHIP programs. Begun in 1991, the Commission is the largest operating program of Henry J. Kaiser Family Foundation and has brought increased analysis and attention to health coverage issues facing the low-income population for over a decade. Through its reports and briefings, the Commission continues to provide up-to-date information on Medicaid and CHIP and assesses options for reform.