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  • State Variation in Medicaid LTSS Policy Choices and Implications for Upcoming Policy Debates

    Issue Brief

    This brief takes a closer look at multiple measures beyond waiver waiting lists to evaluate state choices about optional Medicaid eligibility pathways, spending, and services for seniors and people with disabilities as of 2018. The analysis draws on several KFF resources, including 50-state surveys of Medicaid financial eligibility pathways for seniors and people with disabilities, HCBS waiver programs, and state plan benefits offered, as well as state Medicaid LTSS expenditures reported by Mathematica.

  • Many Nonelderly People With Disabilities Face COVID-19 Risks Similar to Those of the Elderly in Nursing Homes, But Do Not Have Equal Footing When it Comes to Vaccine Priority

    News Release

    While the toll of COVID-19 on nursing home residents has been well documented, less noticed has been the experience of nonelderly people with disabilities who rely on long-term care services and supports outside of nursing homes. In many ways the two groups face similar health risks from the virus, but nonelderly people with disabilities generally do not have the same high priority status for the vaccine, finds a new KFF analysis. As of early February…

  • Potential Impact of Additional Federal Funds for Medicaid HCBS for Seniors and People with Disabilities

    Issue Brief

    The American Rescue Plan includes a provision to increase the federal matching rate (FMAP) for spending on Medicaid HCBS by 10 percentage points from April 1, 2021 through March 31, 2022 provided states maintain state spending levels as of April 1, 2021. This brief discusses the proposal and provides state by state estimates of the potential effects of the policy change. It was updated on May 28 to include key points from the new CMS…

  • Direct Care Workforce Shortages Have Worsened in Many States During the Pandemic, Hampering Providers of Home and Community-Based Services

    News Release

    During the pandemic many states have experienced worsening direct care workforce shortages that have affected providers of home- and community-based long-term care services (HCBS), according to early findings of a new KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. Most states reported workforce shortages as the pandemic’s primary impact on HCBS provided in an enrollee’s home and in group homes. The pandemic has brought new attention among policymakers…

  • Who Didn’t Get a Second Shingrix Shot? Implications for Multidose COVID-19 Vaccines

    Issue Brief

    As the U.S. prepares for nationwide distribution of vaccines to combat COVID-19, some are asking whether people who get the first of two doses will return to complete the series. This analysis draws on Medicare Part D prescription drug claims data for the herpes zoster vaccine Shingrix, which also requires two doses, to shed light on this potential challenge of the leading COVID-19 vaccine candidates.

  • Medicare’s Role for People Under Age 65 with Disabilities

    Issue Brief

    This issue brief examines the role of Medicare for people under age 65 with disabilities, including how this group qualifies for Medicare, the characteristics of people under age 65 with disabilities compared to those age 65 or older, and how sources of supplemental coverage and prescription drug coverage, spending and use of services, and access to care differ for Medicare beneficiaries under age 65 with disabilities and older beneficiaries.

  • Current Flexibility in Medicaid: An Overview of Federal Standards and State Options

    Issue Brief

    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…

  • Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

    Issue Brief

    This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…