Filling the need for trusted information on national health issues

Puerto Rico & USVI: Heading for a Fiscal Cliff When Temporary Medicaid Funds Expire

  • Most funds expire at end of Sept. 2019
  • Ensuing funding shortfalls would hurt budgets, coverage and health systems
  • Puerto Rico and USVI health care systems are fragile and in transition
  • Relief options include raising or eliminating cap on federal Medicaid financing and increasing the federal matching rate

Analysis of Recent Declines in Medicaid and CHIP Enrollment

Between Dec. 2017 and Dec. 2018, Medicaid and CHIP enrollment fell by 1.6 million people, or 2.2 percent, from 74.6 to 73.0 million enrollees.

From Ballot Initiative to Waivers: What is the Status of Medicaid Expansion in Utah?

Voters approved it. The Legislature changed it. We explain where things stand now.

A First Look at North Carolina’s Section 1115 Medicaid Waiver’s Healthy Opportunities Pilots

Under the pilots, Medicaid will pay for non-medical interventions that address housing instability, transportation insecurity, food insecurity, and interpersonal violence and toxic stress for a limited number of high-need enrollees.

Key Facts About Medicaid's Prescription Drug Benefit

Though the Medicaid pharmacy benefit is a state option, all states cover it. We provide an overview of Medicaid’s prescription drug benefit and trends in spending and utilization.

Addressing the Opioid Crisis: Medication-Assisted Treatment at Health Care for the Homeless Programs

Health Care for the Homeless (HCH) programs, a subset of community health centers, play a significant role in addressing the opioid epidemic by providing medication-assisted treatment.

What's Happened under Medicaid Work Requirements in Arkansas?

  • 18,164 individuals lost coverage in 2018
  • 1,910, have reapplied for and regained coverage in 2019 (the clock reset in January for non-compliance)
  • As of March 7, 7,066 enrollees had one month of non-compliance and 6,472 enrollees had two months of non-compliance in the new year

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.

Community Health Center Financing: The Role of Medicaid and Section 330 Grant Funding

Health centers play a vital role in ensuring access to primary care services for medically underserved communities.

An Examination 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 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

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

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.