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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.
As the U.S. tries to address rising rates of mental health issues, the impact of the new 988 national crisis hotline and other innovations will be limited if states don’t have the underlying crisis services available when people are directed to them.
KFF surveyed state Medicaid officials about behavioral health policies related to administration, delivery systems, integrated care, and data analytics.
The health care coverage and financing landscape for people with and at risk for HIV in the U.S. is highly fragmented and made up of a patchwork of payers and programs. This table provides an overview of the major payers and programs that provide coverage and services to people with and at risk of HIV.
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.
This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.
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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