Under a per capita cap, per enrollee spending would be capped, but the total amount of federal dollars to states could vary with enrollment changes and states would not be able to impose enrollment caps. Faced with restrictions in federal financing, states would have to make hard choices. This brief outlines the key measures states could use to manage their budgets and the associated challenges under a per capita cap: raise taxes or make other cuts, reduce benefits, limit coverage of high cost enrollees, reduce rates or implement delivery system reforms, and promote personal responsibility. Each option has challenges that are identified in the brief.
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The American Health Care Act passed by House Republicans in May would go further than existing law to restrict the availability of abortion coverage through private insurance policies. It would ban abortion coverage in all marketplace plans as well as prohibit the use of federal tax credits to purchase any…
This issue brief reviews current federal and state policies on private insurance coverage of abortion services, and the potential conflict between the AHCA provision and state laws regulating private insurance.
This issue brief considers the feasibility of realizing substantial Medicaid cost savings through strategies aimed at improving delivery system and administrative efficiency. We review the literature about the potential for Medicaid cost savings from four strategies related to acute care services: (1) premiums, cost-sharing, and enrollee wellness incentives, (2) complex care management, (3) patient-centered medical homes, and (4) alternative payment models, and another four strategies related to long-term services and supports: (5) tightening financial eligibility rules for long-term care services, (6) promoting private long-term care insurance, (7) expanding home and community-based services (HCBS), and (8) increasing use of managed long-term services and supports.
In his Axios column, Drew Altman examines how the core views Republicans have about Medicaid differ from those of Democrats and Independents, and how those views drive the policy changes they are proposing for the program.
This infographic highlights Medicaid’s role for nursing home care. It includes information about the nation’s growing long term care need and the role Medicaid plays as the primary payer for nursing home care. It also discusses the potential impact of proposals to limit federal Medicaid financing.
This map shows the counties at risk of having no insurer on the marketplace (exchange), created by the Affordable Care Act, in 2018, based on a Kaiser Family Foundation analysis of insurer rate filings and news reports.
Ahead of the June 21 federal deadline for insurers to submit rates for healthcare.gov, the Kaiser Family Foundation has released a new map that will track counties at risk of zero insurers offering plans in the 2018 marketplace. Compiled from a Foundation analysis of insurer filings and news reports, the…
Medicaid currently provides federal matching funds with no pre-set limit to help states cover children with behavioral health needs. Restructuring Medicaid financing as proposed in the American Health Care Act could limit states’ ability to care for these children. The following series of graphics highlights Medicaid’s role for children with behavioral health needs.
Why Does the Medicaid Debate Matter? National Data and Voices of People with Medicaid Highlight Medicaid’s Role
President Trump and other GOP leaders have called for far-reaching changes to Medicaid, including caps and reductions in federal funding for the program. This snapshot provides data on the role Medicaid plays for different population groups as well as perspectives from individuals with coverage through the program. Medicaid, the nation’s public health insurance program for low-income children, adults, seniors, and people with disabilities, covers 1 in 5 Americans, including many with complex and costly needs for medical care and long-term services. Most people covered by Medicaid would be uninsured or underinsured without it. The AHCA would fundamentally change Medicaid in the most significant restructuring of the program since 1965.