Filling the need for trusted information on national health issues

Medicaid

Rebates
Understanding the Medicaid Prescription Drug Rebate Program
The rebate program reduces net federal and state Medicaid spending on prescription drugs. In 2017, Medicaid spent $64 billion on drugs and got $34.9 billion in rebates from manufacturers. Net spending was $29.1 billion.
Managing Costs
Management and Delivery of the Medicaid Pharmacy Benefit
Managing the prescription drug benefit and expenditures is a perennial policy priority for state Medicaid programs, in part because policymakers remain concerned about spending growth. We explore key questions about states’ administration of this benefit.

Long-Term Care
Implications of the Expiration of Medicaid Long-Term Care Spousal Impoverishment Rules
The pending expiration of an ACA provision regarding Medicaid spousal impoverishment rules on Dec. 31 could tip the balance of financial incentives toward institutional long-term care and away from home and community-based services.
Home and Community-Based services
Money Follows the Person: Uncertainty Pending Federal Funding Reauthorization
Funding is set to expire on Dec. 31. The program provides states with enhanced federal matching funds for services and supports needed to help seniors and people with disabilities transition from institutional care to community-based care.
Enrollment Trends
Analysis of Recent Declines in Medicaid and CHIP Enrollment
Following the implementation of the ACA in 2014, there were large increases in Medicaid and CHIP enrollment across states. We analyze recent enrollment trends and discuss potential factors contributing to the enrollment decline and its implications for coverage rates.

Medicaid Work Requirements

work requirements
Understanding the Intersection of Medicaid and Work: What Does the Data Say?
Most (63%) of the 23.5 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.
waivers
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
View pending and approved state Section 1115 waivers for work requirements; eligibility and enrollment restrictions; benefit, copay, and healthy behavior provisions; and behavioral health provisions.
Research Findings
The Relationship Between Work and Health
There is limited evidence on the effect of employment on health, with some studies showing a positive effect of work on health, and others showing no relationship or isolated effects.

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.
Interactive
Medicaid State Fact Sheets
Medicaid and CHIP provide health and long-term care coverage to more than 70 million low-income children, pregnant women, adults, seniors, and people with disabilities. What percentage of people are covered by Medicaid/CHIP in your state?
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.
50-State Survey
A View From the States: Results of a 50-State Medicaid Budget Survey for FY 2019 and FY 2020
The rebate program reduces net federal and state Medicaid spending on prescription drugs. In 2017, Medicaid spent $64 billion on drugs and got $34.9 billion in rebates from manufacturers – for net spending of $29.1 billion.