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This issue brief provides an overview of what Section 1115 Medicaid waivers are, how they are approved and financed, how states have used them, and how they are impacted by health reform. For many years, Section 1115 waivers have been used by states to test new coverage approaches not otherwise allowed under Medicaid program rules.
This brief summarizes the major provisions of a rule proposed by the Centers for Medicare and Medicaid Services that would set forth state requirements for ensuring access to care in state Medicaid programs. It would apply to fee-for-service Medicaid, but not to Medicaid managed care programs.
State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014.
This chartpack draws on data and analysis from a variety of sources to profile the Medicare population through the lens of race and ethnicity, describing life expectancy, demographic characteristics, income and savings, health status and chronic conditions, supplemental coverage, selected measures of access to care, and service utilization.
This issue brief draws on features of the various existing Medicaid home and community-based services (HCBS) programs to identify key policy questions raised by initiatives to streamline Medicaid HCBS, ameliorate institutional bias, and improve administrative simplification.
As more coronavirus cases and deaths are confirmed in jails and prisons, states can utilize programs and other policy actions to mitigate the risk and spread of the disease within facilities and the broader communities in which they are located, according to a new issue brief from KFF.
As the largest payer of substance use disorder services in the United States, Medicaid plays a central role in state efforts to address the opioid epidemic. In addition to increasing access to addiction treatment services through the expansion of Medicaid under the Affordable Care Act (ACA), states are expanding Medicaid addiction treatment services, increasing provider reimbursements, restricting opioid prescribing, and implementing delivery system reforms to improve the quality of treatment services. While many states have been tracking progress and challenges in these efforts, uniqueness of state systems can make it difficult to compare or benchmark across states. This brief draws on analyses provided by the Medicaid Outcomes Distributed Research Network (MODRN), a collaborative effort to analyze data across multiple states to facilitate learning among Medicaid agencies. It profiles the opioid epidemic among the Medicaid population in six states participating in MODRN that also have been hard hit by the opioid epidemic: Kentucky, Maryland, Ohio, Pennsylvania, Virginia, and West Virginia. The brief also draws on interviews with officials from the state Medicaid and other health agencies.
The nation’s low-wage workers face a particular kind of bind.
This brief analyzes the distribution of $50 billion in CARES Act funding for providers and shows that the distribution formula selected by the Department of Health and Human Services favored hospitals with a relatively high share of revenue from private insurance. Hospitals that see a smaller share of patients with private insurance and instead see more patients with Medicare or Medicaid received less funding per hospital bed.
This brief summarizes state changes to Medicaid and CHIP eligibility and enrollment policies in response to the COVID-19 outbreak, beyond those required to access enhanced federal funding. It is based on KFF analysis of approved Medicaid and CHIP state plan amendments (SPAs) and information on state websites as of May 21, 2020.
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