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This report highlights certain policies in place in state Medicaid programs in FY 2024 and policy changes implemented or planned for FY 2025, which began on July 1, 2024 for most states.
A new KFF analysis examines how the coronavirus pandemic is affecting U.S. territories as well as issues related to the upcoming expiration of temporary Medicaid funding for the territories at the end of September. Prior to the pandemic, the U.
More than a year into the public health emergency, the COVID-19 pandemic continues to impact the lives of Americans including those living in the U.S. territories. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. While additional federal funds have been provided over the statutory caps, these funds are set to expire at the end of September 2021. Without additional Congressional action, the territories will lose the vast majority of Medicaid financing which could result in reductions in coverage, services, and provider rates which could negatively impact the territories as they deal with the long-term health and economic consequences of the pandemic. This brief looks at how the pandemic is affecting the territories as well as issues related to the upcoming Medicaid fiscal cliff.
State Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system and payment reform initiatives.
Managed care is the most common delivery system for Medicaid. Most states (42, including DC) use comprehensive managed care plans to provide care to at least some of their Medicaid enrollees, according to KFF’s updated explainer.
The COVID-19 pandemic and the ensuing economic disruption have drawn more attention to longstanding issues related to housing and internet access and how these issues can impact health. As the primary source of health insurance for low-income populations, Medicaid covers a considerable share of people living in homes that are unaffordable, inadequate, or have limited access to the internet. This brief examines housing adequacy, affordability, and internet access within the homes of Medicaid enrollees using data from the 2019 American Community Survey (prior to the COVID-19 pandemic) and assesses the limited role that Medicaid can play in helping to address these challenges.
The U.S territories – American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) – have faced an array of longstanding fiscal and health challenges that were exacerbated by recent natural disasters and most recently by the COVID-19 pandemic. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. Congress is currently debating legislation to address the looming Medicaid funding cliff. This brief builds on data in an earlier brief released in May 2021 examining the effects of the pandemic and the implications of the fiscal cliff and incorporates findings from a questionnaire sent to Medicaid Directors in territories in the summer of 2021.
This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.
As states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.
This policy watch examines the burden of medical debt in North Carolina and the state’s new plan to leverage the Medicaid program to provide debt relief and support access to care for low- and middle-income North Carolinians.
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