Coverage

This issue brief examines the changes in coverage and financing that have occurred under the Affordable Care Act’s (ACA) Medicaid expansion to provide insight into the potential scope of coverage and funding that may be at risk under a repeal of the law.

On Wednesday, January 25, the Kaiser Family Foundation hosted a web briefing for journalists to answer questions and sort through possible scenarios for repealing and replacing the Affordable Care Act, also known as Obamacare, including implications for coverage, the insurance market, the Medicaid program, and women’s health.

Nationwide, an estimated 52 million nonelderly adults live with mental illness, and Medicaid covers nearly one in three (29%) of them, or about 15 million adults. More than 1 in 3 Medicaid enrollees has a mental illness. Mental health treatment rates for Medicaid adults are higher than or similar to those with insurance.

The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would have significant implications. To help inform discussion around increased flexibility, this brief provides an overview of current federal standards and state options in Medicaid and how states have responded to these options in four key areas: eligibility, benefits, premiums and cost sharing, and provider payments and delivery systems.

This brief explains key components of Michigan and Indiana’s Medicaid expansions under Section 1115 demonstration waivers and presents insights from stakeholder interviews and focus groups about early implementation experience.

Michigan and Indiana, led by Republican governors, each obtained a waiver from the Obama Administration to expand Medicaid in ways that differ from the terms of the Affordable Care Act. Notably, both states’ expansions include provisions related to charging enrollees premiums, requiring them to contribute to health accounts and providing…

President Donald Trump and Republicans in Congress are moving to follow through on their campaign promise to repeal and replace the Affordable Care Act (ACA). To gain a better understanding of the personal experiences of Trump voters with health coverage provided through the ACA and the changes they hope to see in the health system moving forward, the Kaiser Family Foundation (KFF) held focus groups in December 2016 with Trump voters in cities in three battleground states (Michigan, Ohio, and Pennsylvania), who had coverage through the Marketplaces or through the Medicaid expansion. This brief and companion video highlight and summarize the range of perspectives expressed at the focus group sessions.

As Republicans in Washington pursue efforts to repeal and replace the Affordable Care Act, what do enrollees in ACA marketplaces and state Medicaid expansions who voted for President Trump want in a health care plan? The Kaiser Family Foundation asked some of them in six focus groups convened in December…

This video provides an overview of the people covered by Medicaid and how Medicaid funds are distributed across enrollment groups and on a per enrollee basis. The video also highlights the implications of reducing federal Medicaid funds through a block grant or per capita cap.

On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected under current law, and 14 million fewer people would be covered by Medicaid than expected under current law. This brief considers five key Medicaid implications of the House bill.