Most (63%) of the 23.5 million adults with Medicaid coverage in the U.S. who are not eligible for both Medicare and Medicaid, and who do not receive federal disability payments, are already working full- or part-time.
The latest enrollment and spending data on Medicaid’s home and community-based services (HCBS), drawing on findings from KFF’s 18th annual 50-state survey of Medicaid HCBS programs. A companion brief examines state policy trends.
The proposed Medicaid Fiscal Accountability Regulation (MFAR) would make technical and complex changes that are likely to have significant implications for provider payment rates and state financing of Medicaid. Here’s what you need to know about it.
These demonstrations would permit states to use Medicaid funds to cover ACA expansion adults and some other nonelderly adults, without being bound by many federal standards related to Medicaid eligibility, benefits and more. In exchange, states would agree to a per capita or aggregate cap on federal financing.
Key issues to watch in 2020 include: Medicaid expansion developments; Section 1115 waiver activity; enrollment and spending trends; benefits, payment and delivery system reforms, and the implications of the 2020 elections.
The rebate program reduces net federal and state Medicaid spending on prescription drugs. In 2017, Medicaid spent $64 billion on drugs and got $34.9 billion in rebates from manufacturers. Net spending was $29.1 billion.
Managing the prescription drug benefit and expenditures is a perennial policy priority for state Medicaid programs, in part because policymakers remain concerned about spending growth. We explore key questions about states’ administration of this benefit.
Medicaid payments for prescription drugs are determined by a complex set of policies, at both the federal and state levels, that draw on price benchmarks. Price benchmarks represent prices paid by different parties at different stages in the drug manufacturing, acquisition, and dispensing processes. We explain how it works.
As of January 2020, 14 states have not adopted the ACA Medicaid expansion. Across all non-expansion states, 4.4 million uninsured nonelderly adults would become eligible for Medicaid if all opted to expand their programs. Our fact sheets show what’s at stake in each state.