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Medicaid: What to Watch in 2018 from the Administration, Congress, and the States

  • What other pending waivers with work requirements will CMS approve? Will such approvals include work requirements for expansion and non-expansion (traditional) populations?  How will these requirements be enforced?
  • Will CMS approve other provisions that restrict eligibility such as time limits, drug testing, lock-outs as well as premiums and cost-sharing?
  • With added complexity, how will these new waivers affect enrollment, program costs and administrative burden and costs?

What Did CMS Approve in the Kentucky Medicaid Waiver?

The waiver includes provisions never before approved by CMS, including:

  • A work requirement as a condition of eligibility.
  • Premiums of up to 4% of income.
  • Multiple coverage “lock-out periods” of up to six months (two of which are new).

Medicaid Waiver Tracker: Which States Have Approved and Pending Section 1115 Medicaid Waivers?

Use our interactive map to view states’ approved and pending waivers according to category:

  • Medicaid expansion
  • Work requirements
  • Eligibility and enrollment restrictions
  • Benefit restrictions, co-pays, healthy behaviors
  • Behavioral health
  • Managed Long Term Services and Supports
  • Delivery system reform

Key Themes in Medicaid Section 1115 Behavioral Health Waivers

We examine recent waiver activity and issues to watch in four key areas.

10 Things to Know about Medicaid: The Facts

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.

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

Our summary reviews findings from 153 studies of the impact of state Medicaid expansions under the ACA published between January 2014 and June 2017.

Medicaid Enrollees and Work Requirements: Lessons From the TANF Experience

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.

Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin

  • Work requirements
  • Time limits
  • Premiums with lock-out for nonpayment

State Medicaid Fact Sheets

Our fact sheets highlight the role and reach of Medicaid in every state.

Infographic: Medicaid’s Role in Addressing the Opioid Epidemic

The Role of Medicaid in Rural America

A look at Medicaid’s role for 52 million nonelderly children and adults living in the most rural areas in the United States.

Infographic: Medicaid’s Role in Nursing Home Care

  • 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.

Medicaid’s Role in Financing Behavioral Health Services for Low-Income Individuals

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.

Data Note: Variation in Per Enrollee Medicaid Spending Across States

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.

Access to Mental Health Services: Medicaid, Private Insurance, and Uninsured

  • 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

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.