- WHat’s Next?As the Biden administration takes office, the ongoing COVID-19 pandemic and economic downturn will shape Medicaid coverage and financing policy in the year ahead. We highlight what to watch — in Washington, state capitals, and even at the Supreme Court.
- TrackerInformation on approved Medicaid emergency authorities to address the COVID-19 Coronavirus emergency. We include details on Medicaid Disaster Relief State Plan Amendments (SPAs), other Medicaid and CHIP SPAs, and other state-reported administrative actions; Section 1115 Waivers; Section 1135 Waivers; and 1915 (c) Waiver Appendix K strategies.
- WaiversForty-five percent of births in the U.S. are covered by Medicaid, and 46 percent of infants are covered by Medicaid or the Children’s Health Insurance Program. The shares are higher among people of color.
Medicaid can play a key role in efforts to improve infant and maternal health and reduce disparities.
- White HouseBarring major legislative initiatives, there are a number of targeted actions that the incoming Biden Administration could implement to expand Medicaid coverage. We examine five of them.
Following several years of declining or flat enrollment growth, states expect Medicaid enrollment and spending each to jump by more than 8 percent in fiscal year 2021, chiefly due to a slumping economy amid the pandemic and federal conditions to maintain coverage to access enhanced federal matching funds. The Medicaid program increasingly will be relied upon to provide health coverage and help soften the economic blow of the pandemic — all at a time when states’ financial capacity to provide such services is stretched thin.
State Medicaid Programs Respond to Meet COVID-19 Challenges: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2020 and 2021
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.
Bookmark our Medicaid waiver tracker page for the latest information on pending and approved Section 1115 Medicaid waivers.
- The BasicsMedicaid covers 1 in 5 low-income Americans, including many with complex and costly needs for care.
- Data Collection Sixty-nine percent of Medicaid beneficiaries nationally get care through managed care organizations. Get state-level, MCO-level and parent firm-level data.
- Managed Care53.9 million Medicaid beneficiaries (69%) received their care through comprehensive risk-based managed care organizations (MCOs), as of July 2018. In FY 2019, payments made to Medicaid MCOs accounted for about 46% of the nearly $604 billion that states and the federal government spent on Medicaid services that year.