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Better Care Reconciliation Act (BCRA): State-by-State Estimates of Reductions in Federal Medicaid Funding

This brief provides national and state-by-state estimates of the reductions in federal spending under the Better Care Reconciliation Act for the period 2020-2029 and for 2029 in order to see the full effect of policy changes over a ten-year period.

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State-by-State Estimates of Reductions in Federal Medicaid Funding Under Repeal of the ACA Medicaid Expansion

Congressional debate around the Affordable Care Act (ACA) has recently included a proposal to repeal the ACA, including the provision allowing states to extend Medicaid to childless adults up to 138% FPL and providing enhanced federal funds for the Medicaid expansion. This brief provides estimates of changes in federal Medicaid funds and Medicaid coverage for adults covered through the ACA expansion if the expansion is eliminated starting in 2020. A repeal of the Medicaid expansion would have significant coverage and financing implications for the 31 states and the District of Columbia that have implemented the expansion.

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No Easy Choices: 5 Options to Respond to Per Capita Caps

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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Strategies to Reduce Medicaid Spending: Findings from a Literature Review

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.

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The Henry J. Kaiser Family Foundation

State Data: What Has Happened to Health Coverage and Financing Under the Affordable Care Act?

As Congress presses forward with efforts to repeal and replace the Affordable Care Act, a new interactive map from the Kaiser Family Foundation provides a window into the changes in health insurance coverage and financing in each state under the 7-year-old law. The ACA increased enrollment in health insurance by…

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Factors Affecting States’ Ability to Respond to Federal Medicaid Cuts and Caps: Which States Are Most At Risk?

This issue brief examines the factors that could affect states’ ability to cope with reductions in federal Medicaid funding of the sort proposed in the House-passed American Health Care Act (AHCA), which would eliminate enhanced federal matching funds for the Affordable Care Act’s Medicaid expansion and convert Medicaid to a per capita cap or block grant system of financing.

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The Henry J. Kaiser Family Foundation

Data Note: Variation in Per Enrollee Medicaid Spending

This data note looks at Medicaid spending per full-benefit enrollee, examining variation by state and by eligibility group, as well as variation within a given state and eligibility group.

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The Henry J. Kaiser Family Foundation

What’s Really At Stake In the Medicaid Spending Debate

In this Axios column, Drew Altman highlights that the federal debate about the American Health Care Act’s Medicaid spending reductions will ultimately be a debate about every state’s general budget spending priorities, as states discuss whether to offset reductions in federal revenues with some combination of cuts to their Medicaid programs, increased taxes, and cuts to spending in other areas.

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The Henry J. Kaiser Family Foundation

No, Medicaid Isn’t Broken

With Medicaid about to be a focal point of debate in the Senate, Drew Altman’s Axios column looks at why the idea that the program is broken is more urban legend than fact.

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Governors’ Proposed Budgets for FY 2018: Focus on Medicaid and Other Health Priorities

This report provides Medicaid highlights from governors’ proposed budgets for state fiscal year (FY) 2018, which runs from July 1, 2017 through June 30, 2018 in most states. Proposed budgets reflect the priorities of the governor and are often blueprints for the legislature to consider.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.