We examine recent waiver activity and issues to watch in four key areas.
In the debate about Medicaid’s future, some critics have made statements at odds with data, research, and basic information about Medicaid. Let’s get the facts straight.
Our summary reviews findings from 153 studies of the impact of state Medicaid expansions under the ACA published between January 2014 and June 2017.
- Most participants with Medicaid coverage are in a working family but live on very strained budgets.
- Medicaid is key for enabling participants to afford coverage and needed care.
- If costs increased, participants were concerned they would face a trade-off between health care and other basic needs.
- What are Section 1115 Medicaid waivers?
- 33 states have 41 approved waivers; 18 states have 21 pending waivers.
- Detailed tables track waivers by state and topic.
We look at a recently-approved amendment to Iowa’s Section 1115 Medicaid demonstration that eliminated 3-month retroactive coverage for nearly all new Medicaid applicants in the state as of November 1, 2017.
1 in 2
Puerto Ricans are enrolled in the island’s Medicaid program.
As some states consider tying Medicaid eligibility to a work requirement, a new brief draws on experiences with the Temporary Assistance for Needy Families program.
We look at waivers that implement the ACA’s Medicaid expansion and highlight themes in approved, pending, and denied provisions to date as well as key issues to watch.
Section 1115 waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. They generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS).
- Work requirements
- Time limits
- Premiums with lock-out for nonpayment
Our fact sheets highlight the role and reach of Medicaid in every state.
- A 1-page distillation of information and statistics about the opioid epidemic and Medicaid’s role in covering addiction treatment services.
- Related slideshow: The Evolving Opioid Epidemic and Medicaid’s Growing Role in Treatment
A look at Medicaid’s role for 52 million nonelderly children and adults living in the most rural areas in the United States.
- Medicaid, the primary payer for nursing home care, covers 6 in 10 nursing home residents.
- 1 in 3 people turning 65 will require nursing home care at some point in his or her life.
Behavioral health conditions affect a substantial number of people in the U.S. and are especially common among people with low incomes. Our brief looks at the key role Medicaid plays in covering and financing behavioral health care.
Medicaid Restructuring and Special Populations
Our 2014 data shows Medicaid per enrollee spending varies greatly across states and groups of enrollees. It is higher, on average, among the aged and individuals with disabilities due to the higher use of acute services and long-term care, and lower for other adults and children.
- Medicaid plays an important role for individuals with mental health conditions, particularly those with low incomes
- Adults with mental illness on Medicaid more likely to receive treatment than those with private insurance or no insurance
- Receipt of psychiatric medication is more common among adults on Medicaid compared to those with private insurance or no insurance