This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending.

Fact Sheet (.pdf)

Three papers from the Foundation’s Commission on Medicaid and the Uninsured examine Medicaid enrollment and spending during the recent recession. The analyses show Medicaid enrollment rose above 50 million people nationally for the first time in 2010, reflecting the program’s counter-cyclical role of helping people who become uninsured when the economy falters, with many turning to Medicaid after losing jobs and employer-based health insurance. Without access to Medicaid coverage, millions more people who suffered economic hardship likely would have joined the ranks of America’s now 50 million uninsured.

The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been the primary cause of the increase in overall Medicaid spending.

The papers include:

Medicaid Spending Growth Over The Last Decade and the Great Recession, 2000 to 2009

Medicaid Spending Growth and the Great Recession, 2007-2009 (A Fact Sheet)

Medicaid Enrollment June 2011 Data Snapshot

With the passage of health reform, the Money Follows the Person (MFP) demonstration grant program was extended five years through 2016 giving states further options to transition Medicaid beneficiaries living in institutions back to the community.

Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. Twenty-nine states and DC are currently participating in this demonstration program and more states plan to apply for MFP grants in the coming year.

In July 2010, the Kaiser Commission on Medicaid and the Uninsured (KCMU) surveyed states about the current status of their MFP program including trends in enrollment, services and per capita spending. The 2010 survey is a follow-up to the 2008 KCMU MFP survey and highlights findings based on responses from twenty-six states.

Aiming to take a snapshot of the state of global health journalism, a report produced for the Kaiser Family Foundation found that shrinking newsroom budgets and the closing of many foreign bureaus are curtailing global health coverage within traditional news media outlets. Advocacy and nongovernmental organizations are increasingly bypassing news outlets and producing their own content, leading to questions about how global health news will evolve. In addition, with outside sources now funding some global health journalism coverage, the long-term sustainability of such funding is brought into question.

Commissioned by the Foundation, journalists Nellie Bristol and John Donnelly interviewed 51 stakeholders in global health journalism, including reporters, editors and producers from mainstream publications and news outlets, and policy, trade and medical journals; writers from advocacy outlets; and staff at journalism fellowship organizations.

Those interviewed suggested that disaster-related health crises and infectious disease outbreaks were the main focus of global health reporting. In many cases, journalists said that they were having a difficult time finding compelling angles for long-time global health stories such as HIV/AIDS or policy stories emerging from Washington, D.C.

Brief (.pdf)

On February 9, 2011, the Foundation convened a forum examining the state of global health journalism drawing on the findings of this report. A summary of that discussion is available online.

As Congress and the Administration increasingly focus on the nation’s budget deficit, many policy experts and several bipartisan deficit reduction panels have proposed significant changes to Medicare to reduce federal spending and address rising health care costs.

This primer provides an overview of Medicare spending trends, how the program is financed, and factors contributing to the growth in Medicare spending. Medicare now covers 47 million seniors and younger people with disabilities, with total expenditures of $524 billion in fiscal year 2010, representing 15 percent of federal outlays.

It also describes the expected effects of provisions in the 2010 health reform law on future Medicare spending. The primer reviews the financial obligations and out-of-pocket spending for people covered by Medicare, outlines several ways to assess Medicare’s long-term fiscal outlook, and discusses future financing challenges facing the program.

Primer (.pdf)

Previous versions:

Primer – July 2009 (.pdf)

Issue Brief – January 2008 (.pdf)

New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the quality-based payments for plans, providing additional payments for 2012 to 2014.

This policy brief by the Kaiser Family Foundation examines the quality ratings of private Medicare Advantage plans by plan characteristics, and beneficiaries’ access to highly rated plans in 2011. The brief shows the potential for Medicare Advantage plans to receive quality-based bonuses under both the 2010 health reform law and the proposed demonstration.

Issue Brief (.pdf)

This brief presents short profiles of four Ohio residents who have benefited from the state’s Money Follows the Person demonstration program, known as HOME Choice.

It was released along with several other resources on Medicaid long-term services and supports at a Feb. 7, 2011 briefing at the Foundation’s Washington, D.C., offices.

Profiles (.pdf)

A new report from the Kaiser Family Foundation examines funding and demographic data for countries receiving support under the U.S. Global Health Initiative (GHI), the Obama Administration’s six-year effort aimed at improving the health and lives of people in the developing world.

The new analysis evaluates data from fiscal year 2010 for six programs in the GHI: HIV/AIDS; tuberculosis; malaria; maternal, newborn, and child health; family planning and reproductive health; and nutrition. These six program areas, along with health systems strengthening and neglected tropical diseases, were identified as the key target areas under the GHI when the effort was first announced in 2009.

The report also includes a special spotlight on the eight “GHI Plus” countries, countries selected by the Administration to serve as “learning laboratories.” Seven of these countries — Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, and Rwanda — receive support in at least five of the six GHI program areas, while the eighth (Nepal) receives support in four areas. Together, the eight countries accounted for one quarter of the total amount of GHI country and regional funding in fiscal year 2010.

Report (.pdf)

Supplemental Charts: GHI Plus Country Funding by Sector (.pdf)

The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care.

The Affordable Care Act (ACA) provides incentives for states to implement certain policies and practices that have proven effective at promoting access to long-term services and supports in the community. States’ experience has shown that operational details can have a significant impact on whether plans to provide more services and supports in the community succeed.

This brief highlights two important aspects of operations in state Medicaid programs that affect access to long-term services and supports in the community: efforts to provide accurate and timely information to consumers, and procedures to make Medicaid eligibility determinations quickly and efficiently.

Issue Brief (.pdf)

This case study of Ohio’s Money Follows the Person demonstration, known as HOME Choice, describes key features of the program and highlights early program experiences.

Ohio was one of 17 states to receive federal funding for the Money Follows the Person (MFP) rebalancing demonstration in January 2007. The state was awarded up to $100 million in enhanced federal matching funds in order to transition roughly 2,200 seniors and people with disabilities from institutions to home and community-based settings and to help Ohio balance its long-term services and support system.

The brief is part of a series that will examine different Money Follows the Person programs across the states. The brief was released along with several other resources on Medicaid long-term services and supports at a Feb. 7, 2011 briefing at the Foundation’s Washington, D.C., offices.

Case Study (.pdf)