Filling the need for trusted information on national health issues
Medicaid
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.
LTC & COVID-19
Long-TERM CARE and COVID
COVID-19 Has Claimed the Lives of 100,000 Long-Term Care Residents and Staff
COVID-19 had killed more than 100,000 long-term care facility residents and staff as of the last week in November. This finding comes at a time when public health experts are predicting a surge in cases after holiday gatherings and increased time indoors due to winter weather, which will have ripple effects on hospitals and nursing homes, given the relationship between community spread and cases in congregate care settings.
- Managed Care
CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes
The final Medicaid managed care rule from the Trump administration changes certain areas of the regulation from 2016, including network adequacy, beneficiary protections, quality oversight and rates and payment. Most of the new provisions take effect on December 14. - 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
Medicaid Initiatives to Improve Maternal and Infant Health and Address Racial Disparities
Forty-five percent of births in the U.S. are covered by Medicaid, and 46 percent of infants are covered by Medicaid or the Children’s Health Insurance Program. The shares are higher among people of color.
Medicaid can play a key role in efforts to improve infant and maternal health and reduce disparities. - Managed care
Growth in Medicaid MCO Enrollment during the COVID-19 Pandemic
Growth in Medicaid managed care enrollment is accelerating as the pandemic wears on. It increased by 11.3% from March 2020 through Sept. 2020 (based on data from 30 states), after growing by 4.1% between March and May (27 states). The six-month cumulative growth rates in Medicaid managed care enrollment across states range from 5.1% in Tennessee to 25.2% in Nevada.
Coronavirus
Coronavirus (COVID-19)
Racial and Ethnic Disparities in COVID-19 Cases and Deaths in Nursing Homes
The pandemic has taken a higher toll on nursing homes with relatively high shares of Black or Hispanic residents. Such homes are more likely to have had a resident die of COVID-19 than homes with lower shares of such residents, and are more likely to have a case of COVID-19 within their facilities. They also tend to have had more widespread outbreaks of the disease. Our analysis is based on data from 13,982 nursing facilities nationwide, or approximately 93 percent of all nursing facilities.
ACA MEDICAID EXPANSION
Supreme Court Case
Eliminating the ACA: What Could It Mean for Medicaid Expansion?
Millions of low-income Americans currently covered by Medicaid likely would become uninsured if the Supreme Court were to strike down the Affordable Care Act in California v. Texas, a legal challenge the high court is scheduled to hear in early November. Eliminating the Medicaid expansion would also have implications for state budgets and economies, as well as provider capacity and the financial health of hospitals and other health care providers.
20th Annual Medicaid Budget Survey
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.
State Medicaid Programs Respond to Meet COVID-19 Challenges: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2020 and 2021
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.
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