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  • Assessing the Presidential Candidates’ Positions on Women’s Health Coverage and Reproductive Health Care

    Issue Brief

    Women's health has been a key issue in the 2012 election with the candidates, President Barack Obama and former Massachusetts Governor Mitt Romney, having different views on women's health care. This brief discusses two major health care issues that are important to women – health coverage and reproductive health care – and summarizes the presidential candidates' stated positions on these topics.

  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • Medicaid Financing: An Overview of the Federal Medicaid Matching Rate (FMAP)

    Issue Brief

    Since its enactment in 1965, the Medicaid program has used the Federal Medical Assistance Percentage (FMAP) to determine the federal government's share of the cost of covered services in state Medicaid programs. On average, the federal share has been 57 percent. Beginning in 2014, the Affordable Care Act (ACA) establishes highly enhanced FMAPs for the cost of services to low-income adults with incomes up to 138% of the Federal Poverty Level (FPL) who are not…

  • Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

    Issue Brief

    This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…

  • Current and Emerging Issues in Medicaid Risk-Based Managed Care: Insights from an Expert Roundtable

    Issue Brief

    Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs. Managed care enrollment may grow more rapidly as states work with the Centers for Medicare & Medicare Services (CMS) to implement initiatives to better integrate Medicare and Medicaid benefits and care for dual eligibles. The Foundation’s Kaiser Commission on…

  • Coverage of Preventive Services for Adults in Medicaid

    Issue Brief

    This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to cover such services for adults. The Affordable Care Act (ACA) provides states the opportunity to earn a one percentage point increase in their federal matching…

  • Raising the Profile of Diplomacy in the U.S. Global Health Response: A Backgrounder on Global Health Diplomacy

    Issue Brief

    The United States recently announced plans to create an Office of Global Health Diplomacy at the State Department, designed to promote the use of diplomacy to advance U.S. global health efforts and support the next phase of the U.S. Global Health Initiative (GHI) in the diplomatic arena. While the office will be new, and there are outstanding questions about its role, it joins a much longer history of diplomatic engagement on international health issues by…

  • Health Homes for Medicaid Beneficiaries with Chronic Conditions

    Issue Brief

    This brief profiles four states that were the first to receive federal approval to take up a state option under the Affordable Care Act to implement health homes for Medicaid beneficiaries with chronic conditions. Almost half of the 9 million people who qualify for Medicaid on the basis of disability suffer from mental illness and 45 percent have three or more diagnosed chronic conditions. Health homes provide an important tool for states trying to manage…

  • A Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage

    Issue Brief

    This historical review finds that the availability of federal funds has served as an effective incentive for states to provide health coverage to meet the health and long-term care needs of their low-income residents despite state budget pressures. The brief examines the history of earlier experiences and provides important context for how states may respond as they weigh the costs and benefits of expanding their Medicaid programs in 2014 as called for under the Affordable…

  • A Guide to the Supreme Court’s Decision on the ACA’s Medicaid Expansion

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court issued its decision in the case challenging the Affordable Care Act (ACA). The Court upheld the constitutionality of the ACA's individual mandate, which requires most people to maintain a minimum level of health insurance coverage beginning in 2014. A majority of the Court also found the ACA's Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied…