On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to Medicaid eligibility, benefits, delivery systems, and program oversight. In exchange, states would agree to a limit on federal financing in the form of a per capita or aggregate cap. States that opt for the aggregate cap and meet performance standards could access a portion of federal savings if actual spending is under the cap. This issue brief explains the key elements of the HAO guidance and considers the implications of the new demonstrations.
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In this May 2019 post for The JAMA forum, Larry Levitt examines how the early discussion and positioning among the presidential candidates offers a glimpse into how a debate about Medicare-for-all might play out.
On November 18, 2019, the Trump Administration released a proposed rule called the Medicaid Fiscal Accountability Regulation (MFAR). This brief provides some context on Medicaid financing, an overview of current state payment and financing rules, the provisions in the rule and potential implications for considerations.
Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Key Medicaid issues to watch in 2020 include: Medicaid expansion developments; Section 1115 waiver activity; enrollment and spending trends; benefits, payment and delivery system reforms, and the implications of the 2020 elections.
KFF Health Tracking Poll – November 2019: Health Care In The 2020 Election, Medicare-for-all, And The State Of The ACA
This poll examines the issues Democrats most want to hear in the debates, their trust of the Democratic candidates on health care, attitudes towards Medicare-for-all and a public option, perceptions of the Affordable Care Act’s health insurance marketplaces, and prospects of legislation to address prescription drug costs.
Drug price concerns in the U.S., including for antiretrovirals, the mainstay of HIV treatment and, increasingly prevention, have prompted the introduction of several policy proposals. One proposal would require manufacturers to provide a rebate to the federal government if prices increase faster than inflation. We assessed list price changes for ARVs under Part D, which is required to cover all or substantially all ARVs.
The bills in this table address a number of related maternity care issues, including extending Medicaid postpartum coverage from 60 days to one year, funding for clinical training on health equity and implicit bias, developing broader networks of maternity care providers in rural areas, and research on the potential benefits of Medicaid coverage for doula care.
This factsheet reviews major sources of coverage for women residing in the U.S. in 2018, discusses the impact of the ACA on women’s coverage, and the coverage challenges that many women continue to face
Drew Altman’s latest Axios column dives into an issue raised in a Joe Biden and Bernie Sanders exchange. In a Medicare-for-all system employers could reap large savings from not having to provide workers health care coverage, but do workers trust that those savings will be passed to them in higher wages?
This side-by-side interactive compares 10 bills to expand public health coverage through Medicare-for-All, a public option and other approaches, that have been introduced in the current Congress. The interactive allows users to compare these proposals across a number of dimensions, including eligibility, benefits, cost sharing, provider payments, and more.