- WHat’s Next?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.
- TrackerInformation 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.
- LTSSOur 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 CentersCommunity 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 EnrollmentPresident 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.
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.
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.
Bookmark our Medicaid waiver tracker page for the latest information on pending and approved Section 1115 Medicaid waivers.
- The BasicsMedicaid covers 1 in 5 low-income Americans, including many with complex and costly needs for care.
- 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.
- Managed Care53.9 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.