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  • Children’s Health Coverage: The Role of Medicaid and CHIP and Issues for the Future

    Issue Brief

    This brief summarizes the role Medicaid and CHIP plays in providing coverage to children, discusses the importance of Medicaid and CHIP for children’s health and well-being, provides an overview of the eligibility for coverage of the remaining uninsured children, and raises issues impacting the future of children’s coverage.

  • Two Year Trends in Medicaid and CHIP Enrollment Data: Findings from the CMS Performance Indicator Project

    Issue Brief

    This brief provides an overview of recent trends in Medicaid and CHIP enrollment as of January 2016, based on data from the Centers for Medicare and Medicaid Services (CMS) produced as part of its Performance Indicator Project. The project was designed to provide timely data on Medicaid and CHIP eligibility and enrollment that are intended to help strengthen data-driven program management and oversight efforts at both the national and state level. They also provide insight…

  • Overview of Medicaid Per Capita Cap Proposals

    Issue Brief

    The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per…

  • Trends in State Medicaid Programs: Looking Back and Looking Ahead

    Issue Brief

    For 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed…

  • ACA Coverage Expansions and Low-Income Workers

    Issue Brief

    This brief highlights low-income workers and the impact of ACA coverage expansions on this population. Low-income workers may not have access to jobs that provide full-time, full-year employment or jobs with comprehensive benefit packages, including health insurance. Medicaid plays an important role in providing health coverage for low-income workers, and coverage expansions implemented under the ACA have produced substantial coverage gains for low-income workers and a corresponding reduction in the uninsured. However, low-income workers in…

  • CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions

    Issue Brief

    On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.

  • Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes

    Issue Brief

    Medicaid payments to hospitals, which include base and supplemental payments, play an important role in hospital finances and can affect beneficiaries’ access to care.This brief provides an overview of Medicaid payments for hospitals and explores the implications of the ACA Medicaid expansion, including changes in uncompensated care, as well as payment policy changes on hospital finances.

  • Connecting the Justice-Involved Population to Medicaid Coverage and Care: Findings from Three States

    Issue Brief

    This brief provides an overview of initiatives to connect the justice-involved population to Medicaid coverage and care in the community in three states—Arizona, Connecticut, and Massachusetts—based on interviews with key stakeholders. These states are leading efforts in these areas and provide key lessons about how to coordinate across health care and corrections and the potential of such initiatives to better link individuals to the physical and behavioral services they need. Each of the case study…

  • Workplace Wellness Programs Characteristics and Requirements

    Issue Brief

    This issue brief summarizes what’s known about workplace wellness programs offered by employers today and the use of financial incentives to encourage workers to participate. Findings are drawn from the KFF/HRET Annual Employer Health Benefits Survey. In addition, the brief reviews proposed changes by the Equal Employment Opportunity Commission (EEOC) in federal standards governing financial incentives by workplace wellness programs and how these changes might balance the use of incentives against other discrimination and privacy…

  • Medicare Advantage 2016 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2016 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.