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This issue brief answers key questions about Medicaid retroactive coverage, describes Iowa’s recent Section 1115 waiver amendment, considers the policy implications of retroactive coverage waivers, and identifies issues to watch.
State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people…
This brief examines family budgets of Medicaid enrollees, how health care costs fit into these budgets, and views on how potential changes to health care could affect them based on 21 interviews with Medicaid enrollees in five cities.
For people who are uninsured and eligible for Affordable Care Act (ACA) marketplace plans, the analysis compares the cost of a premium for the lowest-cost bronze plan with the estimated individual mandate tax penalty for 2018. It finds that more than half (54% or 5.9 million) of the 10.7 million people could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.
This brief looks at the extent to which people have enough savings to meet the cost sharing requirements under private health insurance policies, which have risen substantially in recent years.
The Independent Payment Advisory Board was authorized by the Affordable Care Act to help slow the growth in Medicare spending. These FAQs address common questions about IPAB, including how it was designed to operate and the implications of eliminating it.
Most people with Medicare pay the standard monthly premium for Part B and Part D coverage, which is set to cover 25 percent of Part B and Part D program costs, but a relatively small share of beneficiaries are required to pay higher premiums. This issue brief describes current requirements with respect to Medicare's Part B and Part D income-related premiums and proposed changes under House legislation being considered in November 2017.
This issue brief discusses four key issues related to long-term services and supports (LTSS) including institutional and home and community-based services (HCBS) quality, highlighting major legislative and policy changes over the last 30 years since the passage of the Nursing Home Reform Act.
This analysis of 32 states and Washington, D.C., tracks data on 2018 Affordable Care Act (ACA) marketplace premium increases that insurers directly attributed to the end of cost-sharing reduction payments, which reimburse insurers for providing marketplace health plans with reduced out-of-pocket costs for lower-income people. Following months of uncertainty, the Trump administration announced on Oct. 12 that the payments would be discontinued immediately, although insurers must still offer the subsidized coverage.
While efforts to pass major federal legislation to repeal and replace the Affordable Care Act (ACA) and restructure and reduce federal Medicaid financing may be on hold temporarily, the focus of the Centers for Medicare and Medicaid Services (CMS) and states is expected to turn to achieving significant Medicaid program changes through Section 1115 demonstration waivers. This issue brief presents three questions to help analyze the evolution of federal waiver policy as new waiver proposals…
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