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Medicaid Moving Forward

Issue Brief
  1. FY 2011 Distribution of Medicaid Enrollees by Enrollment Group, FY 2011, http://kff.org/medicaid/state-indicator/distribution-of-medicaid-enrollees-by-enrollment-group/, Kaiser Family Foundation.

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  2. The health reform law also provided for new health insurance Marketplaces and premium subsidies for individuals with income between 100% and 400% FPL.

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  3. Medicaid and CHIP: December 2014 Monthly Applications, Eligibility Determinations and Enrollment Report, CMS, February 23, 2015, http://www.medicaid.gov/medicaid-chip-program-information/program-information/downloads/december-2014-enrollment-report.pdf

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  4. Getting into Gear for 2014: Findings From a 50-State Survey of Eligibility, Enrollment, Renewal and Cost-Sharing Policies in Medicaid and CHIP, 2012-2013 (Kaiser Family Foundation, January 2013), http://kff.org/medicaid/report/getting-into-gear-for-2014-findings-from-a-50-state-survey-of-eligibility-enrollment-renewal-and-cost-sharing-policies-in-medicaid-and-chip-2012-2013/

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  5. States that elect the “209(b)” option are permitted to use financial eligibility standards that are more restrictive than federal SSI rules. However, these states must allow SSI beneficiaries to establish Medicaid eligibility through a “spend-down” by deducting their out-of-pocket medical expenses from their income. See http://kff.org/health-reform/issue-brief/the-affordable-care-acts-impact-on-medicaid-eligibility-enrollment-and-benefits-for-people-with-disabilities/ for a more detailed discussion.

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  6. March 2014 Report to the Congress on Medicaid and CHIP (Medicaid and CHIP Payment and Access Commission (MACPAC), March 2014). See Table 11.

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  7. CMS op.cit.

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  8. Wisconsin provides full Medicaid coverage to adults without dependent children up to 100% FPL although it has not adopted the Medicaid expansion at this time.

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  9. http://kff.org/health-reform/state-indicator/number-of-poor-uninsured-nonelderly-adults-in-the-aca-coverage-gap/ See also Rachel Garfield et al., The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid – An Update (Kaiser Family Foundation, November 2014), http://kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update/

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  10. Robin Rudowitz, Samantha Artiga, and Rachel Arguello, Children’s Health Coverage: Medicaid, CHIP and the ACA (Kaiser Family Foundation, March 2014), http://kff.org/health-reform/issue-brief/childrens-health-coverage-medicaid-chip-and-the-aca/

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  11. Medicaid: A Primer (Kaiser Family Foundation, March 2013), http://kff.org/medicaid/issue-brief/medicaid-a-primer/

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  12. Medicaid Home and Community-Based Services Programs: 2010 Data Update (Kaiser Family Foundation, March 2014), http://kff.org/medicaid/report/medicaid-home-and-community-based-service-programs/

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  13. KCMU estimates based on 2012 CMS National Health Expenditure Accounts data, available at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

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  14. MaryBeth Musumeci, Julia Paradise, Erica Reaves, and Henry Claypool, Benefits and Cost-Sharing for Working People with Disabilities in Medicaid and the Marketplace (Kaiser Family Foundation, October 2014), http://kff.org/report-section/benefits-and-cost-sharing-for-working-people-with-disabilities-in-medicaid-and-the-marketplace-key-themes-8644/

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  15. Federal Register, Volume 78, Number 135, July 15, 2013, http://www.gpo.gov/fdsys/pkg/FR-2013-07-15/html/2013-16271.htm

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  16. KCMU and Urban Institute analysis of Centers for Medicare & Medicaid Services (CMS)-64 data.

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  17. Molly O’Malley Watts, MaryBeth Musumeci, and Erica Reaves, How is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and Supports (LTSS) Today? State Adoption of Six LTSS Options (Kaiser Family Foundation, April 2013), http://kff.org/medicaid/issue-brief/how-is-the-affordable-care-act-leading-to-changes-in-medicaid-long-term-services-and-supports-ltss-today-state-adoption-of-six-ltss-options/

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  18. Genevieve Kenney and Christine Coyer, National Findings on Access to Health Care and Service Use for Children Enrolled in Medicaid, MACPAC Contractor Report No. 1, March 2012.

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  19. Sharon Long, Karen Stockley, Elaine Grimm, and Christine Coyer, National Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid, MACPAC Contractor Report No. 2, June 2012, http://www.urban.org/publications/1001623.html

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  20. Teresa Coughlin, Sharon Long, Lisa Clemans-Cope, and Dean Resnick, What Difference Does Medicaid Make? (Kaiser Family Foundation, May 2013), http://kff.org/medicaid/issue-brief/what-difference-does-medicaid-make-assessing-cost-effectiveness-access-and-financial-protection-under-medicaid-for-low-income-adults/

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  21. Coughlin et al., Kenney and Coyer, and Long et al. op. cit.

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  22. Genevieve Kenney, Brendan Saloner, Nathaniel Anderson, Daniel Polsky, and Karin Rhodes, Access to Care for Low-Income Medicaid and Privately Insured Adults in 2012 in the National Health Interview Survey: A Context for Findings from a New Audit Study, Urban Institute, April 2014, http://www.urban.org/publications/413089.html

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  23. Sandra Decker, “Two-Thirds of Primary Care Physicians Accepted New Medicaid Patients In 2011–12: A Baseline to Measure Future Acceptance Rates,” Health Affairs 32(7), July 2013, http://content.healthaffairs.org/content/32/7/1183.abstract; Andrew Bindman, Andrew Chu, and Kevin Grumbach. Physician Participation in Medi-Cal, 2008, California Healthcare Foundation, July 2010, http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/P/PDF%20PhysicianParticipationMediCal2008.pdf; Peter Cunningham and Jessica May, Medicaid Patients Increasingly Concentrated Among Physicians, Tracking Report No. 16, August 2006, http://www.hschange.com/CONTENT/866/

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  24. Stephen Zuckerman, Aimee Williams, and Karen Stockley, “Trends In Medicaid Physician Fees, 2003–2008,” Health Affairs 28(3), May/June 2009, http://content.healthaffairs.org/content/28/3/w510.full#ref-26

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  25. Report to Congress on the Nation’s Substance Abuse and Mental Health Workforce Issue, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, January 24, 2013, http://store.samhsa.gov/shin/content/PEP13-RTC-BHWORK/PEP13-RTC-BHWORK.pdf

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  26. Medicaid Benefits: Dental Services (Kaiser Family Foundation), http://kff.org/medicaid/state-indicator/dental-services/

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  27. Medicaid: States Made Multiple Program Changes, and Beneficiaries Generally Reported Access Comparable to Private Insurance, General Accountability Office, November 2012, http://www.gao.gov/products/GAO-13-55

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  28. Karin Rhodes, Genevieve Kenney, Ari Friedman, Brendan Saloner, Charlotte Lawson, David Chearo, Douglas Wissoker, and Daniel Polsky,“Primary Care Access for New Patients on the Eve of Health Reform,” JAMA Internal Medicine, June 2014, https://archinte.jamanetwork.com/article.aspx?articleid=1857092; Joanna Bisgaier and Karin Rhodes, “Auditing Access to Specialty Care for Children with Public Insurance,” New England Journal of Medicine, June 16, 2011, http://www.nejm.org/doi/full/10.1056/NEJMsa1013285

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  29. State Standards for Access to Care in Medicaid Managed Care, Office of Inspector General, U.S. Department of Health and Human Services, September 2014, http://oig.hhs.gov/oei/reports/oei-02-11-00320.pdf; Access to Care: Provider Availability in Medicaid Managed Care, Office of Inspector General, U.S. Department of Health and Human Services, December 2014, http://oig.hhs.gov/oei/reports/oei-02-13-00670.pdf

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  30. Daniel Polsky, Michael Richards, Simon Basseyn, Douglas Wissoker, Genevieve Kenney, Stephen Zuckerman, and Karin Rhodes, “Appointment Availability after Increases in Medicaid Payments for Primary Care,” New England Journal of Medicine, February 5, 2015, http://www.nejm.org/doi/full/10.1056/NEJMsa1413299

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  31. Vernon Smith, Kathleen Gifford, Eileen Ellis, Robin Rudowitz and Laura Snyder, Medicaid in an Era of Health & Delivery System Reform: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2014 and 2015 (Kaiser Family Foundation, October 2014), http://kff.org/medicaid/report/medicaid-in-an-era-of-health-delivery-system-reform-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2014-and-2015/

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  32. Rachel Garfield and Katherine Young, Enrollment-Driven Expenditure Growth: Medicaid Spending During the Economic Downturn, FY 2007-2011 (Kaiser Family Foundation, April 2013), http://kff.org/medicaid/report/enrollment-driven-expenditure-growth-medicaid-spending-during/

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  33. Federal Medical Assistance Percentage (FMAP) for Medicaid and Multiplier, http://kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/ (FY 2015).

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  34. Federal and State Share of Medicaid Spending, http://kff.org/medicaid/state-indicator/federalstate-share-of-spending/

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  35. Robin Rudowitz, Laura Snyder, Vernon Smith, Kathleen Gifford, and Eileen Ellis, Implementing the ACA: Medicaid Spending & Enrollment Growth for FY 2014 and FY 2015 (Kaiser Family Foundation, October 2014), http://kff.org/medicaid/issue-brief/implementing-the-aca-medicaid-spending-enrollment-growth-for-fy-2014-and-fy-2015/

     

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