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Snapshots of Health Care in the U.S.

Election 2020: State Health Care Snapshots

Health care is a top issue for voters in the 2020 election. To understand the health care landscape in which the 2020 election policy debates will unfold, these state health care snapshots provide data across a variety of health policy subjects, including health care costs, health coverage—Medicaid, Medicare, private insurance—and the uninsured, women’s health, health status, and access to care.

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Interactive: How State Policies Shape Access to Abortion Coverage

This interactive map shows the increase in states with laws restricting abortion coverage in Medicaid and private insurance since 2010.

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Implications of CMS’s New “Healthy Adult Opportunity” Demonstrations for Medicaid

On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to Medicaid eligibility, benefits, delivery systems, and program oversight. In exchange, states would agree to a limit on federal financing in the form of a per capita or aggregate cap. States that opt for the aggregate cap and meet performance standards could access a portion of federal savings if actual spending is under the cap. This issue brief explains the key elements of the HAO guidance and considers the implications of the new demonstrations.

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Women’s Health Insurance Coverage

This factsheet reviews major sources of coverage for women residing in the U.S. in 2018, discusses the impact of the ACA on women’s coverage, and the coverage challenges that many women continue to face

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Who Could Get Covered Under Medicaid Expansion? State Fact Sheets

The two-page fact sheets provide a snapshot with key data for those who would become eligible for Medicaid under expansion in non-expansion states.

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The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid

In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, 2.3 million poor uninsured adults are in this situation. This brief presents estimates of the number of people in non-expansion states who could have been reached by Medicaid but instead fall into the coverage gap and discusses the implications of them being left out of ACA coverage expansions.

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Key Facts about the Uninsured Population

This issue brief describes how coverage has changed in recent years, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.

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Why it Matters: Tennessee’s Medicaid Block Grant Waiver Proposal

On November 20, 2019, Tennessee submitted an amendment to its longstanding Section 1115 Waiver that would make major financing and administrative changes to its Medicaid program. The Centers for Medicare and Medicaid Services (CMS) certified the waiver as complete and opened a federal public comment period through December 27, 2019. Most significantly, Tennessee is requesting to receive federal funds in the form of a “modified block grant” and to retain half of any federal “savings” achieved under the block grant demonstration. This brief provides a high-level overview of the proposed waiver changes and context for why these changes matter.

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Intimate Partner Violence (IPV) Screening and Counseling Services in Clinical Settings

This brief gives an overview of intimate partner violence (IPV) in the US, the populations most impacted, as well as insurance coverage of IPV screening, counseling, and referral services.

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Lifetime experience of IPV among women

HIV, Intimate Partner Violence (IPV), and Women: An Emerging Policy Landscape

Intimate partner violence has been shown to be associated with increased risk for HIV among women, as well as poorer treatment outcomes for those already diagnosed. This brief reviews the link between IPV and HIV, key policy changes and initiatives that attempt to address these challenges.

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