- SSIStates 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.
- 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.
- Lowering the AgeWhile lowering the Medicare eligibility age based solely on work history to 60 could provide coverage to older adults who are currently uninsured or provide a more affordable option for people with private health insurance coverage, it also could affect Medicaid enrollees in this age range. Some Medicaid enrollees might lose Medicaid coverage when they gain Medicare, and others might become dually eligible for both programs, depending on the details of how it would work.
- U.S. TerritoriesThe pandemic has exacerbated long-standing health care challenges faced by Puerto Rico and other U.S. territories as the end of temporary federal Medicaid funding approaches later this year. 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
- Rx DrugsHow would the Medicaid Rx drug benefit be affected by federal proposals to allow the government to negotiate drug prices in Medicare, limit spread pricing by pharmacy benefit managers, and increase price transparency? We explain in a new Policy Watch. In 2019, Medicaid gross drug spending on prescription drugs was $66 billion; $37 billion was offset by rebates, resulting in $29 billion of net spending that is shared by states and the federal government.
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
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.
Bookmark our Medicaid waiver tracker page for the latest information on pending and approved Section 1115 Medicaid waivers.
- What to WatchThis 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 Sixty-nine percent of Medicaid beneficiaries nationally get care through managed care organizations. Get state-level, MCO-level and parent firm-level data.
- FInancingMedicaid 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.
Medicaid and CHIP Eligibility and Enrollment Policies as of January 2021: Findings from a 50-State SurveyOur 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.