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  • Olmstead’s Role in Community Integration for People with Disabilities Under Medicaid: 15 Years After the Supreme Court’s Olmstead Decision

    Issue Brief

    June 2014 marks the 15th anniversary of the United States Supreme Court’s landmark civil rights decision in Olmstead v. L.C., finding that the unjustified institutionalization of people with disabilities is illegal discrimination. This issue brief examines the legacy of Olmstead, with an emphasis on legal case developments and policy trends emerging in the last five years and the related contributions of the Medicaid program.

  • Potential Supreme Court Decision: Who Will Bear the Coverage “Burdens?”

    Issue Brief

    The Supreme Court is expected to reach a decision by the end of June, 2014 on the cases brought forth by Hobby Lobby and Conestoga Wood Specialties, two for profit corporations challenging the ACA’s contraceptive coverage requirement. The plaintiffs contend that the requirement that they include coverage for certain contraceptive services (emergency contraceptive pills and intrauterine devices) in the insurance plans “substantially burdens” both the corporation’s and the owners’ religious rights. During the arguments, several…

  • Strategies in 4 Safety-Net Hospitals to Adapt to the ACA

    Issue Brief

    This brief examines four safety-net hospitals to learn how they were preparing for the full implementation of the Affordable Care Act (ACA), in order to gain additional insight into the strategies being used and challenges being faced among safety-net hospitals across the country.

  • A Look At CBO Projections For Medicaid and CHIP

    Issue Brief

    This brief examines the latest Congressional Budget Office (CBO) projections for federal Medicaid and CHIP spending over the 2014-2024 period. CBO’s budget projections, also known as “baseline” projections, reflect CBO’s best judgment about how the economy and other factors will affect federal revenues and spending under existing laws. The brief also examines CBO estimates of the coverage effects of the Affordable Care Act (ACA) on Medicaid and CHIP enrollment and spending. Understanding the CBO baseline…

  • CHIP Enrollment Snapshot: December 2013

    Issue Brief

    This report focuses on changes in monthly CHIP enrollment between December 2012 and December 2013. This is a long standing report that collects monthly CHIP enrollment data for December (and June, not reported here) going back to 2000. While the data provided in this report are not directly comparable to the data released by CMS, they provide context for the preliminary data released by CMS, illustrating historical trends in CHIP enrollment.

  • Medicaid Enrollment Snapshot: December 2013

    Issue Brief

    This report focuses on changes in monthly Medicaid enrollment between December 2012 and December 2013. This is a long standing report series that collects monthly Medicaid enrollment data for December (and June, not reported here) going back to 2000. While the most recent data included in this report predate preliminary data released by CMS that show the early effects of full implementation of the ACA, this report series is an important source of historical trend…

  • Individual Market Enrollment Ticks Up in Early 2014

    Issue Brief

    This early look at the growth in the individual or nongroup market during the first three months of 2014 uses first quarter enrollment data submitted by insurance companies to state regulators to estimate the size of the market at the end of March. It includes both on and off exchange enrollment and is net of any people leaving the market (whether through plan cancellations or general churn in the market). It does not include the…

  • The Affordable Care Act and Insurance Coverage in Rural Areas

    Issue Brief

    Rural populations face disparities compared to metropolitan populations in health care. While rural individuals were not more likely to be uninsured than metropolitan counterparts pre-Affordable Care Act, they were poorer and less likely to have private insurance. With coverage changes in the ACA involving an expansion of Medicaid for poor and near-poor populations, decisions by states with large rural populations may cause rural residents to have disparate access to coverage, which may exacerbate cost and…

  • The U.S. Government and Global LGBT Health: Opportunities and Challenges in the Current Era

    Issue Brief

    In recent years, the U.S. government has paid increasing attention to the health and human rights of lesbian, gay, bisexual and transgender (LGBT) individuals around the world, utilizing both multilateral and bilateral channels. Still, however, many LGBT individuals continue to face stigma, discrimination, and violence, both within and outside of the health sector, which compromise their ability to access needed health services and can adversely affect health status. Moreover, in many countries, the barriers faced…

  • Paying for Prescribed Drugs in Medicaid: Current Policy and Upcoming Changes

    Issue Brief

    The federal government has proposed new rules that aim to make Medicaid outpatient drug reimbursement policies more closely match the cost of obtaining and filling prescriptions. However, the change in policy may have varying effects on reimbursement, depending on the state’s current approach and the type of drug in question. This paper explains current Medicaid pharmacy reimbursement methodology and examines the potential effect of the proposed rule changes.