Medicaid
Medicaid HCBS
How Could $400 Billion New Federal Dollars Change Medicaid Home and Community-Based Services?
President Biden and some in Congress want up to $400 billion in new funding to expand access to Medicaid home and community-based services and boost the direct care workforce. In our updated analysis, we discuss more about how HCBS money could be used. HCBS assist with self-care, such as eating and bathing, and household activities, such as preparing meals, for people who need help with these tasks due to health or functional needs. An increase of $400 billion could boost spending for Medicaid HCBS by at least 33 percent annually.
- SSI
Supplemental Security Income for People with Disabilities: Implications for Medicaid
States generally must provide Medicaid to poor people with a disability who receive federal Supplemental Security Income (SSI). We describe key characteristics of SSI enrollees, explain the SSI eligibility criteria and eligibility determination process, and consider the implications of changes in the SSI program for Medicaid, including the effects of the COVID-19 pandemic and resulting economic downturn and proposals supported by President Biden that Congress might consider. - U.S. Territories
Challenges in the U.S. Territories: COVID-19 and the Medicaid Financing Cliff
The pandemic has exacerbated long-standing health care challenges faced by Puerto Rico and other U.S. territories. The expiration of a temporary Medicaid funding at the end of September would result in the loss of over 80% of U.S. territories’ Medicaid funding and could result in reductions in coverage, services, and provider rates. - Coverage Gap
Taking A Closer Look At Characteristics of People in the Coverage Gap
Twelve states have not adopted the ACA Medicaid expansion to adults with incomes through 138% of poverty, leaving 2.2 million people in the coverage gap. They would be eligible for Medicaid if their state adopted the expansion but currently do not qualify for Medicaid and have incomes below poverty, making them ineligible for subsidies in the ACA Marketplace. As policy makers debate whether and how to extend coverage to people in the gap, understanding the characteristics of this group can help inform policy decisions. - Medicaid Expansion
The Status of Medicaid Expansion in Missouri and Implications for Coverage and Cost
Missouri voters last year approved a ballot measure to expand Medicaid as of July 1, 2021. A state court ruling put the expansion in limbo. At stake is Medicaid eligibility for 127,000 uninsured nonelderly adults who fall into the ACA coverage gap. If Missouri does not expand Medicaid, the state would forgo over $1 billion in federal money in fiscal years 2022-2023. Estimated state costs of expansion during this time are $310 million.
Prescription Drugs
Analysis
Costs and Savings under Federal Policy Approaches to Address Medicaid Prescription Drug Spending
Several recent policy proposals address the cost of prescription drugs to both consumers and payers Congress has already started hearings on other legislation to target drug prices and could include such proposals in forthcoming budget reconciliation bills. This brief analyzes leading federal approaches to address Medicaid prescription drug spending, discusses (where available) a range of cost estimates for each policy, and assesses what drives those estimates.
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Coronavirus
Medicaid Managed Care
Growth in Medicaid MCO Enrollment during the COVID-19 Pandemic
This data note looks at state Medicaid managed care enrollment data through March 2021 to assess the impact of the COVID-19 pandemic and economic crisis on Medicaid enrollment. Data collected for 29 states show that the rate of Medicaid managed care enrollment growth was 18.8% when comparing managed care enrollment from March 2020 through March 2021. The rate accelerated compared to March 2020 through September 2020 and reversed the trend seen from March 2019 to March 2020 when aggregate growth declined.
ACA MEDICAID EXPANSION
Literature Review
Building on the Evidence Base: Studies on the Effects of Medicaid Expansion, February 2020 to March 2021
Our latest literature review provides context for these expansion debates by summarizing evidence from nearly 200 studies about the effects of Medicaid expansion that were published between February 2020 and March 2021.
The report highlights study findings across multiple key themes of interest, including mortality, cancer, chronic disease, and disabilities, sexual and reproductive health, behavioral health, economic impacts on states and providers, disparities and social determinants of health.
LTC & COVID-19
Long-TERM CARE and COVID
More than 184,000 long-term care facility residents and staff have died of COVID-19. Recognizing that ongoing vaccination efforts are crucial to ending the pandemic, CMS issued an Interim Final Rule with Comment Period (IFC) that establishes new vaccine reporting and/or education requirements for nursing homes and ICF/IIDs as of May 21st, 2021. Public comments are due July 12, 2021, after which CMS may revise the rule. Our new brief explores how the new @CMSGov Interim Final Rule’s vaccine reporting and education requirements apply differently to various types of long-term care facilities.
How Do CMS’s New COVID-19 Vaccine Reporting and Education Rules Apply To Different Long-Term Care Settings?
More than 184,000 long-term care facility residents and staff have died of COVID-19. Recognizing that ongoing vaccination efforts are crucial to ending the pandemic, CMS issued an Interim Final Rule with Comment Period (IFC) that establishes new vaccine reporting and/or education requirements for nursing homes and ICF/IIDs as of May 21st, 2021. Public comments are due July 12, 2021, after which CMS may revise the rule. Our new brief explores how the new @CMSGov Interim Final Rule’s vaccine reporting and education requirements apply differently to various types of long-term care facilities.
Medicaid Budget Survey
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Medicaid Spending and Enrollment Trends Amid the COVID-19 Pandemic – Updated for FY 2021 & Looking Ahead to FY 2022
The public health and economic effects of the pandemic continue to put pressure on Medicaid spending and enrollment. State Medicaid agencies expect overall FY 2021 enrollment to exceed original projections (30 of 37 responding states). Two-thirds of states with updated projections for FY 2021 expect total Medicaid spending to exceed original projections. State projections for FY 2022 were mixed if spending growth would be higher or lower relative to FY 2021
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State Medicaid Programs Respond to Meet COVID-19 Challenges: Results from a 50-State Medicaid Budget Survey
Our annual in-depth, state-specific examination of policy changes and initiatives in Medicaid programs find that this year many involve responses to the COVID-19 pandemic. We present the latest on eligibility and enrollment, provider rates, delivery systems, long-term services and supports, pharmacy actions, benefits, cost-sharing, telehealth and more.
Medicaid Work Requirements
Work Among Medicaid Adults: Implications of Economic Downturn and Work Requirements
Most (63%) of the 22 million adults with Medicaid coverage in the U.S. who are not eligible for both Medicare and Medicaid, and who do not receive federal disability payments, were already working full- or part-time prior to the pandemic, according to the most recent data available. Among those not working, caregiving responsibilities were a primary reason, as well as illness, disability or school attendance. The industries in which many Medicaid enrollees work, including construction, restaurants, and food services, have been among those hit hardest by the pandemic.
- Tracker
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
Bookmark our Medicaid waiver tracker page for the latest information on pending and approved Section 1115 Medicaid waivers. - What to Watch
The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020
This issue brief summarizes findings from 404 studies of the impact of state Medicaid expansions under the ACA published beginning in January 2014 (when the coverage provisions of the ACA went into effect) and January 2020. It groups outcomes into three broad categories: coverage, access, and economic measures. - Data Collection
Medicaid Managed Care Market Tracker
Sixty-nine percent of Medicaid beneficiaries nationally get care through managed care organizations. Get state-level, MCO-level and parent firm-level data. - FInancing
Medicaid Financing: The Basics
Medicaid represents $1 out of every $6 spent on health care in the U.S. and is the major source of financing for states to provide coverage of health and long-term care for low-income residents. We explain how financing for the program works.
- Survey
Medicaid and CHIP Eligibility and Enrollment Policies as of January 2021: Findings from a 50-State Survey
Our 19th annual survey of Medicaid and CHIP program officials provides data on eligibility levels in every state. It also examines key aspects of state enrollment and renewal procedures in place during the COVID-19 public health emergency.
Latest from Kaiser Health News
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KHN’s ‘What the Health?’: Hot Covid Summer
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How a Doctor Breaks Norms to Treat Refugees and Recent Immigrants
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California facilita que residentes de bajos ingresos obtengan y mantengan una cobertura de salud gratuita
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California Makes It Easier for Low-Income Residents to Get and Keep Free Health Coverage