Medicaid

Following a successful ballot measure on Aug. 4, Missouri became the 38th state (plus D.C.) to adopt the Affordable Care Act’s Medicaid expansion. The approved measure adds Medicaid expansion to the state’s constitution. Missouri is the second state to expand Medicaid during the coronavirus pandemic, after a ballot measure passed in Oklahoma in June. Twelve states have not adopted expansion.

The large number of COVID-19 cases and deaths among people in long-term care facilities has brought renewed attention to whether there has been sufficient federal and state oversight of nursing homes, whose residents are among the most vulnerable to serious illness and death if infected with the novel coronavirus. We review the current landscape, answer key questions about nursing home oversight and regulations, and explain how federal policy has changed due to the pandemic.

Millions of Americans rely on Medicaid drug coverage both for treating acute problems and for managing ongoing chronic or disabling conditions. Though optional, all states provide pharmacy benefit coverage in Medicaid and administer the benefit in different ways within federal guidelines. Our state fact sheets offer a snapshot of the administration and delivery of Medicaid pharmacy benefits in each state. They are based on data from a survey of states conducted between June and December 2019.

The temporary boost in federal Medicaid funding enacted as part of FFCRA will soften the economic blow of COVID-19 on states, but it’s unlikely to fully offset state revenue declines or forestall budget shortfalls stemming from the pandemic. The $64B in fiscal relief that states could receive if the temporary FMAP increase were extended through Sept. 2021 still would be small relative to projected revenue losses, and states likely would need to make big cuts to their budgets.

Most (62%) of the 22 million adults with Medicaid coverage in the U.S. who are not eligible for both Medicare and Medicaid, and who do not receive federal disability payments, are already working full- or part-time. We highlight data related to the work status and financial security of Medicaid adults prior to the coronavirus pandemic as well as findings from focus groups conducted with Medicaid enrollees in January 2020.