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  • Key Themes in Medicaid Section 1115 Behavioral Health Waivers

    Issue Brief

    State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people with behavioral health needs, and financing delivery system reforms.

  • Dual Eligible Demonstrations: The Beneficiary Perspective

    Issue Brief

    This issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.

  • The Gap in Medigap

    Perspective

    This policy insight examines the low rate of Medigap coverage among people under age 65 with disabilities on Medicare and the federal law that governs consumer rights and protections related to Medigap open enrollment.

  • Key State Policy Choices About Medicaid Home and Community-Based Services

    Issue Brief

    State policy choices about Medicaid home and community-based services (HCBS) shape these benefits in important ways for the seniors and people with disabilities who rely on them to live independently in the community. This issue brief presents the latest data from the KFF's annual survey of Medicaid HCBS program policies in all 50 states and DC.

  • Medicaid Home and Community-Based Services Enrollment and Spending

    Issue Brief

    Medicaid continues to be the primary payer for home and community-based services (HCBS) that help seniors and people with cognitive, physical, and mental health disabilities and chronic illnesses with self-care and household activities. This issue brief presents Medicaid HCBS enrollment and spending data from KFF's annual state survey and includes tables with detailed state-level data.

  • Implications of the Expiration of Medicaid Long-Term Care Spousal Impoverishment Rules for Community Integration

    Issue Brief

    To financially qualify for Medicaid long-term services and supports (LTSS), an individual must have a low income and limited assets. In response to concerns that these rules could leave a spouse without adequate means of support when a married individual needs LTSS, Congress created the spousal impoverishment rules in 1988. Originally, these rules required states to protect a portion of a married couple’s income and assets to provide for the “community spouse’s” living expenses when determining nursing home financial eligibility, but gave states the option to apply the rules to home and community-based services (HCBS) waivers.
    Section 2404 of the Affordable Care Act (ACA) changed the spousal impoverishment rules to treat Medicaid HCBS and institutional care equally from January 2014 through December 2018. Congress subsequently extended Section 2404 through December 2019. This issue brief answers key questions about the spousal impoverishment rules, presents 50-state data from a 2018 Kaiser Family Foundation survey about state policies and future plans in this area, and considers the implications if Congress does not further extend Section 2404.