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  • Awaiting New Medicaid Managed Care Rules: Key Issues to Watch

    Issue Brief

    More than half of all Medicaid beneficiaries now receive their services in risk-based managed care plans, and states’ use of managed care is expanding. States operate their own Medicaid managed care programs within federal rules and requirements. The federal regulations were last updated in 2002 and a new proposed rule is expected in Spring 2015. This brief identifies key issues in the regulation and discusses how CMS might address them.

  • Repayments and Refunds: Estimating the Effects of 2014 Premium Tax Credit Reconciliation

    Issue Brief

    This analysis estimates the range of repayment or refund amounts of the advanced premium tax credits issued to enrollees who experience income volatility between the time of enrollment and tax credit reconciliation. Using a simulation model among all households eligible for advance payments of the premium tax credits under the Affordable Care Act, it estimates that half would owe a repayment while 45 percent would be issued a refund of some or all of premium…

  • Community Health Centers: A 2013 Profile and Prospects as ACA Implementation Proceeds

    Issue Brief

    Community health centers are an integral part of the health care safety-net, providing access to care for nearly 22 million people in underserved communities. The ACA established trust fund for health center growth, and with increased patient revenues attributable to expanded coverage, health centers’ grant funding to support care of the uninsured can go further. This brief provides a 2013 data profile of health centers; highlights pre-ACA differences between health centers in Medicaid expansion and…

  • The Effects of the Medicaid Expansion on State Budgets: An Early Look in Select States

    Issue Brief

    This brief examines the early state budget effects of the ACA Medicaid expansion in three states: Connecticut, New Mexico, and Washington State. States were asked about savings and costs in Medicaid, behavioral health, corrections, uncompensated care spending, etc. as well as revenues. Findings from a study looking at Kentucky are also included.

  • Consumer Assets and Patient Cost Sharing

    Issue Brief

    Higher cost sharing in private insurance has been credited with helping to slow the growth of health care costs in recent years. For families with low incomes or moderate incomes, however, high deductibles, out-of-pocket limits and other cost sharing can be a potential barrier to care and may lead these families to significant financial difficulties. This issue brief uses information from the Federal Reserve Board's 2013 Survey of Consumer Finances to look at how household…

  • Medicaid Moving Forward

    Issue Brief

    Medicaid is the nation’s main public health insurance program for people with low incomes, and it is the single largest source of health coverage in the U.S., covering nearly 70 million Americans. Medicaid also finances 16% of total personal health spending in the nation. States design and administer their own Medicaid programs within federal requirements, and states and the federal government finance the program jointly. As a major payer, Medicaid is a core source of…

  • The Coverage Provisions in the Affordable Care Act: An Update

    Issue Brief

    This brief examines the coverage provisions of the Affordable Care Act , providing an update on how they have been implemented and assessing their impact five years after the law's enactment. It also discusses key issues for coverage going forward.

  • Trends in Medicaid Spending Leading up to ACA Implementation

    Issue Brief

    This paper presents data on Medicaid spending during the years leading up to the implementation of the Affordable Care Act (ACA). It uses administrative data to first examine overall spending trends and trends by service type. We then draw on additional data to analyze per enrollee spending growth during this period, both by service type and by eligibility group, to understand what drove Medicaid spending.

  • The Cost of Care with Marketplace Coverage

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2015 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).