Policy Watch

Quick-hitting policy analysis, polling, and updates on the key issues facing the country.

Recent Developments and Key Issues to Watch with Medicaid Section 1115 Waivers

This policy watch describes the current landscape of Section 1115 waivers and highlights key issues to watch: the outcome of litigation related to Georgia’s waiver, as well as the Biden Administration’s decisions on pending requests from Tennessee and other states.

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Will Long COVID Exacerbate Existing Disparities in Health and Employment?

Rates of self-reported long COVID are one-quarter to one-third higher among adults who are female, transgender, Hispanic, and without a high-school degree than among all adults, according to federal survey data. In this policy watch, we consider whether long COVID could exacerbate existing disparities in health and employment.

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Medicaid and the Inflation Reduction Act of 2022

The recent passage of the Inflation Reduction Act of 2022 (IRA) includes a number of climate, tax, and health care provisions and prescription drug reforms. This policy watch explores the potential impacts of the Inflation Reduction Act on overall Medicaid spending as well as implications for Medicaid beneficiaries.

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2022 State Ballot Initiatives on Abortion Rights

On June 24, 2022, the Supreme Court overturned Roe v. Wade, eliminating the federal Constitutional standard that had protected the right to abortion. Absent any federal standard addressing a right to abortion, states may set their own policies banning or protecting abortion. Explicit protections or restrictions in state Constitutions will limit the authority of state legislators to pass new abortion laws. Presently, five states have Constitutional amendments restricting state courts from interpreting a right to abortion or requiring state funding of abortion. Ten states have state supreme court rulings interpreting a right to abortion in their state Constitutions, but these rulings can be overturned. Most recently, in June 2022, the Iowa Supreme Court overturned its previous decision interpreting the right to abortion in its state Constitution. However, explicit state Constitutional amendments recognizing or restricting abortion remove the role of the state courts in interpreting the state Constitution to evaluate whether a right to abortion is recognized in that state.

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Medicaid Pandemic Enrollment Policies Helped Drive a Drop in the Uninsured Rate in 2021, but the Coverage Gains Are at Risk

According to data from the Census Bureau, the uninsured rate declined in 2021, driven by an increase in public coverage, particularly Medicaid coverage, as we all as an increase in Marketplace coverage.

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The Safer Communities Act: Changes to Medicaid EPSDT and School Based Services

To help reduce gun violence and expand access to mental health services for children, the Bipartisan Safer Communities Act includes a number of Medicaid/CHIP provisions to ensure access to comprehensive health services and to strengthen school-based mental health care. In 2019, Medicaid covered nearly four in ten children nationwide, providing coverage for a comprehensive set of physical and behavioral health services. Mental health concerns among children have increased in recent years, and access and utilization of mental health care may have worsened during the pandemic. As directed by the Safer Communities Act, on August 18 the Centers for Medicare and Medicaid Services (CMS) released informational bulletins to guide state implementation of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit (particularly mental health services) and expand access to school-based Medicaid services. This policy watch examines Medicaid’s current role in providing coverage for EPSDT and school-based health services, current challenges, and changes to these services included in the new legislation.

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