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This brief describes current network adequacy and availability standards for Medicaid managed care plans, presents related findings from KFF’s 22nd annual Medicaid budget survey, and summarizes proposed changes to network adequacy and access rules in the Managed Care NPRM.
Medicaid enrollment increased since the start of the pandemic, primarily due to the continuous enrollment provision.KFF estimates that between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision.The Medicaid continuous enrollment provision stopped “churn” among Medicaid enrollees.States approaches to unwinding the continuous enrollment provision vary.
As states begin to unwind the COVID emergency continuous enrollment provision and resume Medicaid disenrollments, early data from a handful of states – highlighted on KFF’s regularly-updated Medicaid Enrollment and Unwinding Tracker -- reveal wide variation in disenrollment rates.
This policy watch discusses Medicaid unwinding and how enrollees who qualified for Medicaid through the pregnancy pathway are at risk of losing Medicaid coverage, particularly those living in states who have not implemented Medicaid expansion and have not extended postpartum Medicaid coverage.
Crisis behavioral health services provide access to trained mental health professionals for individuals experiencing mental health or substance use emergencies--an alternative to emergency departments and law enforcement. About three-quarters of responding state Medicaid programs do not cover all three core crisis services for FFS adults, but most states cover at least one core behavioral health crisis service. As crisis response systems continue to grow and expand, states are navigating a variety of concerns—including workforce shortages, training needs, geographic challenges, and uncertainty about sustainable funding.
KFF surveyed state Medicaid officials about behavioral health policies related to administration, delivery systems, integrated care, and data analytics.
A KFF survey of Medicaid enrollees largely fielded prior to states resuming their efforts to redetermine Medicaid enrollees’ eligibility reveals many enrollees are unprepared for the renewal process that could result in some losing their coverage either due to eligibility changes or paperwork issues.
This brief gauges Medicaid enrollees’ knowledge of the Medicaid renewal process and possible disenrollment, following the end of continuous enrollment on March 31, 2023.
The unwinding of the continuous enrollment provision will play out differently across the states based on policy choices states have made and variation in their administrative infrastructures. Some states have adopted multiple policies that are more likely to promote continued coverage among those who remain eligible.
A new KFF analysis finds that an estimated 1.7 million Medicaid enrollees could become ineligible for federal Medicaid under proposed work requirements and presents state-by-state projections, based on estimates of coverage loss from the Congressional Budget Office (CBO).
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