What Did CMS Approve in the Indiana and Kentucky Medicaid Waivers?
Key provisions include Medicaid spending cuts, enhancements and work requirements, as well as #opioid/behavioral health proposals and more.
Use our interactive map to view states’ approved and pending waivers according to category:
- Medicaid expansion
- Work requirements
- Eligibility and enrollment restrictions
- Benefit restrictions, co-pays, healthy behaviors
- Behavioral health
- Managed Long Term Services and Supports
- Delivery system reform
On Feb. 2 we held a reporters-only web briefing to explore states’ pending and approved Medicaid waivers and examine the implications for state Medicaid programs and the people they serve.
How Might Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waiver Programs?
Waivers that condition Medicaid eligibility on meeting a work requirement could adversely affect people with disabilities who have limitations that interfere with their ability to work but do not rise to the SSI level.
A key source of federal funding expired Sept. 20, 2017. Temporary funding runs out March 31.
- What other pending waivers with work requirements will CMS approve? Will such approvals include work requirements for expansion and non-expansion (traditional) populations? How will these requirements be enforced?
- Will CMS approve other provisions that restrict eligibility such as time limits, drug testing, lock-outs as well as premiums and cost-sharing?
- With added complexity, how will these new waivers affect enrollment, program costs and administrative burden and costs?
- Federal funding for CHIP for six years, through FY2023.
- Continues the 23 percentage point enhanced federal match rate for CHIP established by the ACA, but reduces the federal match rate to the regular CHIP rate over time.
- Extends requirement for states to maintain for coverage for children from 2019 thru 2023. After Oct. 1, 2019, the requirement is limited to children in families with incomes at or below 300% FPL.
We examine recent waiver activity and issues to watch in four key areas.
In the debate about Medicaid’s future, some critics have made statements at odds with data, research, and basic information about Medicaid. Let’s get the facts straight.
Our summary reviews findings from 153 studies of the impact of state Medicaid expansions under the ACA published between January 2014 and June 2017.
A look at national trends drawing upon the latest enrollment and spending data for the three main Medicaid home and community-based services (HCBS) programs. We also highlight key findings on 2016 program policies, such as waiting lists, managed long-term services and supports, and provider payment rates.
As some states consider tying Medicaid eligibility to a work requirement, a new brief draws on experiences with the Temporary Assistance for Needy Families program.
Our fact sheets highlight the role and reach of Medicaid in every state.
- A 1-page distillation of information and statistics about the opioid epidemic and Medicaid’s role in covering addiction treatment services.
- Related slideshow: The Evolving Opioid Epidemic and Medicaid’s Growing Role in Treatment
A look at Medicaid’s role for 52 million nonelderly children and adults living in the most rural areas in the United States.
- Medicaid, the primary payer for nursing home care, covers 6 in 10 nursing home residents.
- 1 in 3 people turning 65 will require nursing home care at some point in his or her life.
Behavioral health conditions affect a substantial number of people in the U.S. and are especially common among people with low incomes. Our brief looks at the key role Medicaid plays in covering and financing behavioral health care.
Medicaid Restructuring and Special Populations
Our 2014 data shows Medicaid per enrollee spending varies greatly across states and groups of enrollees. It is higher, on average, among the aged and individuals with disabilities due to the higher use of acute services and long-term care, and lower for other adults and children.
- Medicaid plays an important role for individuals with mental health conditions, particularly those with low incomes
- Adults with mental illness on Medicaid more likely to receive treatment than those with private insurance or no insurance
- Receipt of psychiatric medication is more common among adults on Medicaid compared to those with private insurance or no insurance