• u.S. Territories

    Implications of the Medicaid Fiscal Cliff for the U.S. Territories

    The U.S territories – American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) – have faced an array of longstanding fiscal and health challenges that were exacerbated by recent natural disasters and most recently by the COVID-19 pandemic. While temporary federal funds have helped, they are set to expire at the end of September 2021 unless Congress extends the assistance. We examine the effects of the pandemic and the implications of the looming Medicaid funding cliff.
  • Premiums & Cost Sharing

    Understanding the Impact of Medicaid Premiums & Cost-Sharing: Updated Evidence from the Literature and Section 1115 Waivers

    Research on premiums and cost-sharing for low-income populations indicates that these policies lead to reduced coverage, worse access to care, and increased financial burden. We review the research. We also summarize approved Section 1115 waivers allowing eight states to charge premiums to enrollees below 150% FPL and analyze available data on the impact of these premiums from five states.
  • 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 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.
Medicaid Budget Survey

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