An Analysis of Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs
Antivirals, including those that treat hepatitis C and HIV/AIDS, cost Medicaid more money (before rebates) than any other drug group each year from 2014 to 2017.
Medicaid in the U.S. Territories: Program Features, Challenges, and Changes
- Medicaid enrollment increased in Puerto Rico and USVI following the hurricanes
- Most territories have struggled with provider shortages
- The expiration of temporary Medicaid funds in Sept. 2019 could have negative consequences for coverage and services
How Quickly are States Connecting Applicants to Medicaid and CHIP Coverage?
States with faster application processing:
- Had broader eligibility for Medicaid and CHIP
- Were more likely to receive most applications online and allow individuals to upload documentation automatically
- Were more likely to process the majority of renewals automatically
Potential Changes to Medicaid Long-Term Care Spousal Impoverishment Rules
The pending expiration of an ACA provision regarding Medicaid spousal impoverishment rules could tip the balance of financial incentives toward institutional long-term care and away from home and community-based services.
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
View states’ approved and pending waivers according to topic:
- Work Requirement Waivers
- Waivers with Eligibility and Enrollment Restrictions
- Waivers with Benefit, Copay, and Healthy Behavior Provisions
- Waivers with Behavioral Health Provisions
January State Data for Medicaid Work Requirements in Arkansas
- 18,164 individuals lost coverage in 2018
- 1,452 reapplied for and regained coverage in 2019 (the clock reset in January for non-compliance)
- As of Feb. 7, 2019, 8,895 enrollees had one month of non-compliance in the new year
CMS’s 2018 Proposed Medicaid Managed Care Rule: A Summary of Major Provisions
Key areas of proposed changes include:
- Network adequacy
- Beneficiary protections
- Quality oversight
- Rates and payment
The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
Findings from 202 studies of the impact of state Medicaid expansions published between January 2014 and February 2018.
- Coverage
- Access, Utilization, Affordability and Health Outcomes
- Economic Outcomes
What's in the Kentucky Medicaid Waiver that was Re-approved in November 2018?
- A work requirement as a condition of eligibility
- Premiums of up to 4% of income
- Multiple coverage “lock-out periods”
- Elimination of retroactive eligibility coverage and NEMT benefit for most expansion adults
- New deductible and incentive rewards accounts
The re-approved waiver includes very few changes from the version approved in January 2018.
Stewart v. Azar: Explaining the Court’s Decision on Kentucky’s Medicaid Waiver
The court blocked Kentucky’s implementation of much of the waiver and sent it back to HHS to reconsider. CMS has re-opened the comment period through August 18, 2018.
Some related resources:
Medicaid State Fact Sheets
An updated collection of state Medicaid fact sheets provides snapshots of Medicaid coverage and spending nationally and in each state.
Estimated Impacts of the Proposed Public Charge Rule on Immigrants and Medicaid
- Medicaid/CHIP enrollment likely to decline.
- Over 14M Medicaid and CHIP enrollees live in a household with a noncitizen.
- 94 percent of noncitizens who entered the U.S. without legal permanent resident status have characteristics the government could weigh against them in public charge determinations.
Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act
We look at the key Medicaid provisions in the bipartisan anti-opioids legislation.
The Essentials
Trending: Medicaid's Future
- Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
- “Partial” Medicaid Expansions Could Limit States’ Spending But Cover Fewer People at a Higher Federal Cost Compared to Traditional ACA Expansions
- “Partial Medicaid Expansion” with ACA Enhanced Matching Funds: Implications for Financing and Coverage
- Medicaid: What to Watch in 2019 from the Administration, Congress, and the States
Podcast: KHN’s ‘What The Health?’ The Karma Of Cutting Medicare 