Medicaid
Unwinding the Continuous Enrollment Provision
States Are Employing a Range of Strategies As They Prepare to Resume Medicaid Disenrollments During the Unwinding
How the unwinding of the pandemic-era federal continuous enrollment provision affects Medicaid enrollees and state budgets will vary according to states’ differing approaches and administrative capabilities.
Our 21st annual survey of state Medicaid and CHIP officials finds that many states are using an array of strategies to promote continuity of coverage, while others have policies that may make it harder for people who are still eligible to retain coverage. Staffing shortages and systems limitations could also affect whether eligible people are able to remain enrolled.
Read the news release
Our 21st annual survey of state Medicaid and CHIP officials finds that many states are using an array of strategies to promote continuity of coverage, while others have policies that may make it harder for people who are still eligible to retain coverage. Staffing shortages and systems limitations could also affect whether eligible people are able to remain enrolled.
Read the news release
Rural Hospitals Face Renewed Financial Challenges, Especially in States That Have Not Expanded Medicaid
This data note examines rural hospitals’ operating margins in recent years. After seeing higher margins early in the pandemic, likely due to government relief funds, rural hospitals now face renewed challenges, especially in states that have not expanded Medicaid.
10 Things to Know About Medicaid Managed Care
Managed care is the dominant delivery system in Medicaid. With 72% of beneficiaries enrolled in comprehensive managed care organizations (MCOs), plans have played a key role in responding to the pandemic and are expected to work with states in conducting outreach and providing support to enrollees during the unwinding of the continuous enrollment requirement.Enrollment and Spending Patterns Among Medicare-Medicaid Enrollees
In 2019, Medicare-Medicaid enrollees comprised 17% of the traditional Medicare population but accounted for 33% of traditional Medicare spending. They made up 14% of the total Medicaid population and accounted for 32% of all Medicaid spending.A Look at Recent Medicaid Guidance to Address Social Determinants of Health and Health-Related Social Needs
New guidance from CMS expands opportunities for states to cover health-related social needs that contribute to poor health –e.g. housing instability, homelessness, and nutrition insecurity – through 1115 Medicaid waivers and managed care.A Look at Substance Use Disorders (SUD) Among Medicaid Enrollees
7.3% of Medicaid enrollees ages 12 to 64 had at least one clinically-identified substance use disorder (SUD) in 2019. That is a measure of how often SUD is identified & possibly treated in clinical settings. Overall prevalence of SUD is likely higher.
Medicaid Expansion
Building on the Evidence Base: Studies on the Effects of Medicaid Expansion
An agreement among state lawmakers to expand Medicaid in North Carolina would reduce to 10 the number of states that have not expanded Medicaid under the Affordable Care Act.
This literature review provides context for ongoing state expansion debates by summarizing evidence from nearly 200 studies from February 2020 to March 2021 on the effects of state Medicaid expansions. The review builds on an earlier report (examining over 400 studies) concluding that expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers.
This literature review provides context for ongoing state expansion debates by summarizing evidence from nearly 200 studies from February 2020 to March 2021 on the effects of state Medicaid expansions. The review builds on an earlier report (examining over 400 studies) concluding that expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers.
Mental and Behavioral Health
Most State Medicaid Programs Intend to Keep Pandemic-Era Expansions in Telehealth for Behavioral Health Services
We draw on findings from KFF’s Behavioral Health Survey to examine how state Medicaid programs have utilized telehealth to increase access to behavioral health care during the pandemic.
States’ expansion of telehealth has taken a variety of forms, including the addition of audio-only coverage of behavioral health services; the expansion of the types of behavioral health services that can be delivered via telehealth; and the expansion of provider types that may be reimbursed for telehealth delivery of behavioral health services.
States reported high utilization of telehealth for behavioral health care across all or most populations served by Medicaid. Utilization has declined from peak levels but remains higher than before the pandemic. Most states report that they are likely to keep many of the expansions in place.
Read the News Release
States’ expansion of telehealth has taken a variety of forms, including the addition of audio-only coverage of behavioral health services; the expansion of the types of behavioral health services that can be delivered via telehealth; and the expansion of provider types that may be reimbursed for telehealth delivery of behavioral health services.
States reported high utilization of telehealth for behavioral health care across all or most populations served by Medicaid. Utilization has declined from peak levels but remains higher than before the pandemic. Most states report that they are likely to keep many of the expansions in place.
Read the News Release
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Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
Bookmark our Medicaid waiver tracker page for the latest information on pending and approved Section 1115 Medicaid waivers. Medicaid: What to Watch in 2023
How many people will lose Medicaid coverage when states resume disenrollments this spring following the end of the pandemic-era continuous enrollment provision? Will more states adopt Medicaid expansion? What’s being done to reduce racial disparities in health? We explore these and other issues to watch in Medicaid in 2023.Medicaid State Fact Sheets
Medicaid and the Children’s Health Insurance Program (CHIP) provide health and long-term care coverage to almost 90 million low-income children, pregnant women, adults, seniors, and people with disabilities in the U.S.10 Things About Medicaid Long Term Services and Supports
Nearly $1 in every $10 spent on health care in the U.S. in 2020 went to long-term services and supports (LTSS). Medicaid was the single largest payer, accounting for 54% of the more than $400 billion spent on LTSS that year. Spending on home and community-based services was $245 billion, while $157 billion was spent on institutional LTSS such as nursing facility care.
50-State Medicaid Budget Survey Archives
Our annual surveys tracking Medicaid spending and enrollment trends, published since 2000. The surveys also examine state Medicaid policy actions around eligibility and enrollment, provider rates, provider taxes/fees, premiums and cost-sharing, benefits and pharmacy, long-term care and delivery system and payment reform.
