Medicaid
Coronavirus
Coronavirus (COVID-19)
COVID-19 Vaccine Access for People with Disabilities
Many nonelderly people with disabilities who rely on long-term care services and supports (LTSS) face COVID-19 risks similar to those of the elderly in nursing homes. At least 6,500 people have died from COVID-19 in settings such as group and personal care homes and adult day care programs, but with varied state reporting, this is an incomplete picture of how nonelderly people with disabilities have been affected. People who rely on LTSS outside of nursing homes include adults with a variety of conditions such as autism, Down syndrome, serious mental illness and traumatic brain injuries.
- WHat’s Next?
Medicaid: What to Watch in 2021
As the Biden administration takes office, the ongoing COVID-19 pandemic and economic downturn will shape Medicaid coverage and financing policy in the year ahead. We highlight what to watch — in Washington, state capitals, and even at the Supreme Court. - Tracker
Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19
Information 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. - LTSS
State Variation in Medicaid LTSS Policy Choices and Implications for Upcoming Policy Debates
Our review of a range of measures, beyond waiver waiting lists, finds substantial state variation in adoption of policies to expand Medicaid for seniors and people with disabilities, with states’ ACA expansion status not a strong predictor of policy choices related to seniors and people with disabilities. Understanding current state-level variation in Medicaid eligibility, spending, and services for seniors and people with disabilities is important to inform upcoming policy debates. - Community Health Centers
Biden Wants to Partner with Health Centers to Promote More Equitable Access to COVID-19 Vaccines
Community health centers say supply and staffing shortages are their biggest challenges in deploying the COVID-19 vaccines, issues the Biden Administration will need to confront in proposing to use health centers as key distribution points for the vaccines. They will likely have mobile clinics, and will help staff mass vaccination sites and provide onsite and pharmacy-based vaccines in hard-to-reach communities. - ACA OPen Enrollment
ACA Open Enrollment Matters For Medicaid Coverage, Too
President Biden’s executive order to reopen ACA Marketplace enrollment for a special enrollment period has the potential to reach millions of uninsured people – including those eligible for MMedicaid. Data show 7.3M uninsured people were eligible for Medicaid before the pandemic.
LTC & COVID-19
Long-TERM CARE and COVID
New COVID-19 Cases and Deaths in Long-Term Care Facilities Are Dropping Following the Introduction of Vaccines
The number of residents contracting and dying of COVID-19 in nursing homes has declined markedly following the introduction of vaccination efforts in long-term care facilities. Resident deaths from COVID-19 in nursing homes have decreased by two-thirds (66%) since vaccination efforts began in late December. New cases of the novel coronavirus among residents have fallen even more sharply, by 83%. Is the end of the long-term care crisis within sight?
Medicaid Work Requirements
Data Analysis
Work Among Medicaid Adults: Implications of Economic Downturn and Work Requirements
Most (63%) 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, were already working full- or part-time prior to the pandemic, according to the most recent data available. Among those not working, caregiving responsibilities were a primary reason, as well as illness, disability or school attendance. The industries in which many Medicaid enrollees work, including construction, restaurants, and food services, have been among those hit hardest by the pandemic.
ACA MEDICAID EXPANSION
State Fact Sheets
Who Could Get Covered Under Medicaid Expansion?
Twelve states have not adopted the ACA Medicaid expansion. Across all non-expansion states, 4 million uninsured nonelderly adults would become eligible for Medicaid if all opted to expand their programs. Who would become eligible for Medicaid if these states chose to expand? Our interactive map links you to state-specific fact sheets with key data that answers that question.
20th Annual Medicaid Budget Survey
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Medicaid Enrollment & Spending Growth: FY 2020 & 2021
Following several years of declining or flat enrollment growth, states expect Medicaid enrollment and spending each to jump by more than 8 percent in fiscal year 2021, chiefly due to a slumping economy amid the pandemic and federal conditions to maintain coverage to access enhanced federal matching funds. The Medicaid program increasingly will be relied upon to provide health coverage and help soften the economic blow of the pandemic — all at a time when states’ financial capacity to provide such services is stretched thin.
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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.
Prescription Drugs
Fact Sheets
Medicaid Pharmacy Benefits State Fact Sheets
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.
- Tracker
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. - The Basics
10 Things to Know about Medicaid
Medicaid covers 1 in 5 low-income Americans, including many with complex and costly needs for care. - Data Collection
Medicaid Managed Care Market Tracker
Sixty-nine percent of Medicaid beneficiaries nationally get care through managed care organizations. Get state-level, MCO-level and parent firm-level data. - Managed Care
10 Things to Know About Medicaid Managed Care
53.9 million Medicaid beneficiaries (69%) received their care through comprehensive risk-based managed care organizations (MCOs), as of July 2018. In FY 2019, payments made to Medicaid MCOs accounted for about 46% of the nearly $604 billion that states and the federal government spent on Medicaid services that year.
