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This brief summarizes the status and implications of the Trump Administration final regulations, published in December 2019, that change how ACA Marketplace plans that include coverage for abortion must bill and consumers must pay premiums for that coverage.
On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in areas including network adequacy, beneficiary protections, quality oversight, and rates and payment.
Patient-provider email messaging accelerated early in the COVID-19 pandemic as more patients sought medical care remotely, and the addition of billing codes for digital health services and subsequent changes in insurers’ payment policies have enabled providers to bill insurers and patients for messaging. This analysis examines the typical cost of patient-provider email messaging in 2020 and 2021 using private health insurance claims data. The typical cost for an email messaging claim was $39 in 2021,…
Substance use disorders contribute to a growing number of deaths, yet they often go undiagnosed and untreated. While nearly three-quarters of Medicaid enrollees with a diagnosed substance use disorder utilized some type of treatment service in 2020, medication treatment rates varied widely, being much lower for alcohol use disorder than opioid use disorder, and lower among Black enrollees and youth compared to their counterparts. Treatment rates varied considerably across states and average Medicaid spending for…
KFF's survey examines adults who had Medicaid coverage in early 2023, just before states resumed eligibility checks and disenrollments after pandemic-era protections ended. Nearly a quarter (23%) of adults who say they were disenrolled from Medicaid since early 2023 report being uninsured now. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year.
Compared to the general population, individuals who are incarcerated have higher rates of mental illness, substance use disorder, and chronic disease. However, the federal “inmate exclusion” policy prohibits Medicaid coverage for people who are incarcerated (except for limited inpatient hospital services). When people leave incarceration, they are at greater risk of overdose death and suicide, as well as hospitalization and emergency department use. In a new explainer, KFF examines a new waiver opportunity that allows…
A new KFF review of more than three dozen studies published between April 2021 and June 2023 finds that Medicaid expansion under the Affordable Care Act is associated with beneficial effects on a range of sexual and reproductive health outcomes. The studies, which echo findings of previous research, find that Medicaid expansion is associated with increased health insurance coverage prior to and after pregnancy, as well as increased access to, and utilization of, both prenatal…
A new analysis of data from KFF’s Survey on Racism, Discrimination, and Health shows Black women are more likely than other groups to report being treated unfairly by a health care provider in recent years because of their race and ethnicity and that these experiences have health consequences. For example, among Black women who used health care in the past three years, 34% report at least one of three consequences because of a negative experience…
As of May 21, 2024, half of all U.S. states have enacted a law that prohibits or limits youth access to gender affirming care. This Data Note examines the uptick in this lawmaking, which was slow at first but then quickened, increasing 7-fold in an eight-month period in 2023.
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. During the COVID-19 pandemic, states suspended their Medicaid eligibility renewals in exchange for additional federal funding, ensuring continuous health coverage for enrollees. States recently have resumed eligibility renewals and as of…
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