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This report highlights certain policies in place in state Medicaid programs in FY 2024 and policy changes implemented or planned for FY 2025, which began on July 1, 2024 for most states.
This Health Policy 101 chapter explores why polls and surveys are essential for understanding health policy issues and aims to teach you how to evaluate polls effectively. It covers the importance of polls in policy analysis, key considerations for interpretation, polling methodologies, and questions to assess the usefulness of polls. The chapter concludes with real-world examples demonstrating how polling informs policy debates.
This brief examines how the CMS Innovation Center (also known as CMMI) and Section 402 demonstration authority could become pathways for the Biden Administration to implement policy changes related to prescription drug costs.
All qualified health plans offered in the Marketplace cover the "essential health benefits" (EHB), including: Ambulatory patient services (outpatient care you get without being admitted to a hospital) Emergency services Hospitalization Maternity and newborn care (care before and after your baby is born) Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain…
This brief presents five key facts about Medicaid coverage among individuals living in rural areas. It draws on recent data to describe enrollment patterns, differences by state Medicaid expansion status, characteristics of the rural Medicaid population, and patterns of health care use among enrollees.
The U.S territories – American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) – have faced longstanding fiscal and health challenges exacerbated by recent emergencies. This issue brief provides background on how Medicaid financing differs between U.S. territories and states and what these differences mean for funding as well as health care coverage and access.
“Short-term limited-duration” insurance plans are intended to fill a temporary gap in health coverage, such as when someone is between jobs. The maximum duration of short-term plans varies by state. Short-term plans must disclose to consumers that these plans are “NOT comprehensive health coverage.” Short-term plans often do not have the consumer protections found in Marketplace plans. For example, short-term plans can exclude coverage of pre-existing health conditions. Also, many short-term plans do not cover essential health…
The latest data on U.S. health spending are now available on the Health Spending Explorer, an interactive tool that allows users to explore trends in health spending by federal and local governments, insurers, nursing care, hospital, and other service providers, and consumers. The tool captures just-released 2022 data from the federal government, when national health expenditures totaled nearly $4.5 trillion. Overall spending rose 4.1% in 2022, with almost all categories of health spending experiencing growth.…
This issue brief describes how Medicaid home care operates—including who is eligible and the systems in place to promote program integrity in its delivery—and the challenges of using new CMS data to identify unusual billing patterns or potential fraud in the program.
Based on your current income and asset amounts, you may qualify for Medicaid. Under the current rules, Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports. You might also qualify for extra financial assistance to help with the cost of Medicare Part D prescription drug coverage. To find out…
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