Medicaid
LTC & COVID-19
Long-TERM CARE and COVID
Patterns in COVID-19 Cases and Deaths in Long-Term Care Facilities in 2020
Despite efforts to slow the spread of the virus in long-term care facilities, many states experienced the worst COVID-19 outbreaks and highest number of deaths in December. The disturbing trends revealed in the data underscore the importance of current efforts to vaccinate this high priority group. The novel coronavirus has had a disproportionate impact on older adults in general and nursing home and other long-term care facility residents and staff in particular. Six percent of all COVID-19 cases nationally and 38 percent of deaths from the virus have been associated with long-term care settings.
- 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. - Waivers
Tennessee & Other Medicaid 1115 Waiver Activity: Implications for the Biden Administration
In its final days, the Trump Administration approved controversial waivers that had been pending (most recently for Tennessee), extended other waivers more than a year before expiration, and took steps to try to prolong the process for withdrawing or amending approved waivers. This issue brief takes a closer look at this recent activity to understand implications for the Biden Administration. - White House
5 Targeted Actions a Biden Administration Could Use to Expand Medicaid Coverage
Barring major legislative initiatives, there are a number of targeted actions that the incoming Biden Administration could implement to expand Medicaid coverage. We examine five of them.
Coronavirus
Coronavirus (COVID-19)
Medicaid Maintenance of Eligibility (MOE) Requirements: Issues to Watch
The Center for Medicare and Medicaid Services’ Interim Final Rule reverses earlier guidance related to Medicaid maintenance of eligibility requirements tied to enhanced federal funding for states during the COVID-19 public health emergency. We outline the changes and examine what happens when they expire. We also discuss key issues to consider looking ahead, including potential decisions the incoming Biden administration will face.
ACA MEDICAID EXPANSION
Spending & Enrollment
Medicaid Expansion Enrollment and Spending Leading up to the COVID-19 Pandemic
In FY 2019, the ACA Medicaid expansion group represented 20 percent of all Medicaid enrollment nationally. Spending on the expansion group represented 16 percent of all Medicaid spending that year – and was primarily federal funds. Medicaid expansion enrollment and spending are likely to grow at a fast pace during the pandemic. Estimates suggest that expansion enrollment growth has outpaced overall Medicaid enrollment growth from February to August 2020.
Medicaid Work Requirements
Data Analysis
Understanding the Intersection of Medicaid, Work and COVID-19
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.
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.
