- What will happen to Medicaid enrollment when the continuous enrollment requirement tied to federal pandemic funding for states ends? After being hit hard by the pandemic the first two years, how will long-term care settings deal with the virus this year? How will providers respond to the vaccine mandate for health care staff? A number of issues are at play this year that could affect coverage and financing under Medicaid, from the course of the pandemic to state decisions about Medicaid expansion and the fate of the Build Back Better Act. We highlight the key ones to watch.
- An estimated 6.7 million children in the U.S. have special education plans, and over two-thirds of these children have special health care needs. Over half of children with special education plans are covered by Medicaid. We explain how Medicaid and special education services intersect and explore the pandemic’s implications for kids receiving such services.
- Before the pandemic, 10 percent of enrollees had a gap in Medicaid coverage of less than a year. Enrollment “churn” went away during COVID-19 because of continuous enrollment requirements tied to special Medicaid funding. But disenrollments will resume when the requirements end. The Build Back Better Act includes provisions to phase out the requirement and place limits on how quickly states could disenroll people.
The Role of Community Health Centers in the Territories and Freely Associated States During the PandemicCommunity Health centers in the U.S. territories and Freely Associated States help fill a need for primary care and other services. We examine the role they have played in the pandemic, including administering vaccines and meeting the rising need for mental health services. Temporary Medicaid and federal grant funding boosts helped health centers during the pandemic. The Build Back Better Act would permanently increase federal Medicaid matching rates and overall funds for the territories.
- Most states reported having at least one Medicaid delivery system and payment reform initiative in place as of July 2021 aimed at improving quality and costs. However, the research about the effects of such efforts is not conclusive. State efforts to advance Medicaid delivery system and payment reform initiatives will continue to be shaped by the COVID-19 pandemic’s effects, including lack of stability in utilization patterns, labor shortages, and provider capacity.
Bookmark our Medicaid waiver tracker page for the latest information on pending and approved Section 1115 Medicaid waivers.
- Social DeterminantsThe COVID-19 pandemic exacerbated existing health disparities for a broad range of populations, but specifically for people of color. We examine how adults are faring on a range of social determinants of health. Black and Hispanic adults fared worse than White adults across almost all 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.