• u.S. Territories

    Implications of the Medicaid Fiscal Cliff for the U.S. Territories

    The U.S territories – American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) – have faced an array of longstanding fiscal and health challenges that were exacerbated by recent natural disasters and most recently by the COVID-19 pandemic. While temporary federal funds have helped, they are set to expire at the end of September 2021 unless Congress extends the assistance. We examine the effects of the pandemic and the implications of the looming Medicaid funding cliff.
  • Premiums & Cost Sharing

    Understanding the Impact of Medicaid Premiums & Cost-Sharing: Updated Evidence from the Literature and Section 1115 Waivers

    Research on premiums and cost-sharing for low-income populations indicates that these policies lead to reduced coverage, worse access to care, and increased financial burden. We review the research. We also summarize approved Section 1115 waivers allowing eight states to charge premiums to enrollees below 150% FPL and analyze available data on the impact of these premiums from five states.
  • Coverage Gap

    Taking A Closer Look At Characteristics of People in the Coverage Gap

    Twelve states have not adopted the ACA Medicaid expansion to adults with incomes through 138% of poverty, leaving 2.2 million people in the coverage gap. They would be eligible for Medicaid if their state adopted the expansion but currently do not qualify for Medicaid and have incomes below poverty, making them ineligible for subsidies in the ACA Marketplace. As policy makers debate whether and how to extend coverage to people in the gap, understanding the characteristics of this group can help inform policy decisions.
  • Medicaid HCBS

    Children with Special Health Care Needs: Coverage, Affordability, and HCBS Access

    Our analysis examines key characteristics of children with special health care needs, the affordability and adequacy of their health coverage, and the implications for such children of potential new federal Medicaid money to assist families in caring for them.  
    Medicaid is a significant source of coverage for such children, including HCBS. During the pandemic, children have experienced health care disruptions, mental health challenges, and economic hardships, and these issues may have been intensified for those with special health care needs.
  • Housing

    Housing Affordability, Adequacy, and Access to the Internet in Homes of Medicaid Enrollees

    Medicaid covers a considerable number of people living in homes that are unaffordable, inadequate or have limited access to the internet, all of which can affect health. We look at the limited role Medicaid can play in addressing these challenges. State Medicaid programs can add certain housing supports for high-need enrollees as part of home and community-based services programs, through 1115 waivers, and a limited set of other options. Medicaid can also connect enrollees to social services.
Medicaid Budget Survey

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