Filling the need for trusted information on national health issues

An Analysis of Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs

Antivirals, including those that treat hepatitis C and HIV/AIDS, cost Medicaid more money (before rebates) than any other drug group each year from 2014 to 2017.

Medicaid in the U.S. Territories: Program Features, Challenges, and Changes

  • Medicaid enrollment increased in Puerto Rico and USVI following the hurricanes
  • Most territories have struggled with provider shortages
  • The expiration of temporary Medicaid funds in Sept. 2019 could have negative consequences for coverage and services

How Quickly are States Connecting Applicants to Medicaid and CHIP Coverage?

States with faster application processing:

  • Had broader eligibility for Medicaid and CHIP
  • Were more likely to receive most applications online and allow individuals to upload documentation automatically
  • Were more likely to process the majority of renewals automatically

Potential Changes to Medicaid Long-Term Care Spousal Impoverishment Rules

The pending expiration of an ACA provision regarding Medicaid spousal impoverishment rules could tip the balance of financial incentives toward institutional long-term care and away from home and community-based services.

Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State

View states’ approved and pending waivers according to topic:

  • Work Requirement Waivers
  • Waivers with Eligibility and Enrollment Restrictions
  • Waivers with Benefit, Copay, and Healthy Behavior Provisions
  • Waivers with Behavioral Health Provisions

January State Data for Medicaid Work Requirements in Arkansas

  • 18,164 individuals lost coverage in 2018
  • 1,452 reapplied for and regained coverage in 2019 (the clock reset in January for non-compliance)
  • As of Feb. 7, 2019, 8,895 enrollees had one month of non-compliance in the new year

CMS’s 2018 Proposed Medicaid Managed Care Rule: A Summary of Major Provisions

Key areas of proposed changes include:

  • Network adequacy
  • Beneficiary protections
  • Quality oversight
  • Rates and payment


The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review

Findings from 202 studies of the impact of state Medicaid expansions published between January 2014 and February 2018.
  • Coverage
  • Access, Utilization, Affordability and Health Outcomes
  • Economic Outcomes

What's in the Kentucky Medicaid Waiver that was Re-approved in November 2018?

  • A work requirement as a condition of eligibility
  • Premiums of up to 4% of income
  • Multiple coverage “lock-out periods”
  • Elimination of retroactive eligibility coverage and NEMT benefit for most expansion adults
  • New deductible and incentive rewards accounts

The re-approved waiver includes very few changes from the version approved in January 2018.

Medicaid State Fact Sheets

An updated collection of state Medicaid fact sheets provides snapshots of Medicaid coverage and spending nationally and in each state.

Estimated Impacts of the Proposed Public Charge Rule on Immigrants and Medicaid

  • Medicaid/CHIP enrollment likely to decline.
  • Over 14M Medicaid and CHIP enrollees live in a household with a noncitizen.
  • 94 percent of noncitizens who entered the U.S. without legal permanent resident status have characteristics the government could weigh against them in public charge determinations.

Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act

We look at the key Medicaid provisions in the bipartisan anti-opioids legislation.