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  • Summary of HHS’s Final Rule on Nondiscrimination in Health Programs and Activities

    Issue Brief

    On May 18, 2016, the Department of Health and Human Services (HHS) published a final rule to implement Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in health coverage and care based on race, color, national origin, age or disability, and, for the first time sex. This Issue Brief provides a technical summary of Section 1557 and the final rule and highlights new protections and provisions included in the law and rule. Notably, Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in health care. Moreover, the proposed rule extends the definition of sex discrimination to include discrimination on the basis of gender identity. In addition, the final rule establishes regulations related to the provision of language assistance services based on long-standing HHS policy guidance.

  • 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 guidance about how states can access the funds and examples of how funds can be used.

  • Few Nursing Facility Residents and Staff Have Received the Latest COVID-19 Vaccine

    Issue Brief

    KFF analysis found that over one-fifth of all U.S. COVID-19 deaths occurred in long-term care facilities despite but as of January 14th, 2024, only 38% of residents and 15% of staff were “up-to-date” with their COVID-19 vaccines, which the CDC defines as having received the updated Fall 2023 vaccine. Those rates are lower than uptake was for the 2022 vaccine.

  • Working-Age Adults with Disabilities Living in the Community

    Issue Brief

    In September 2023, the National Institutes of Health designated people with disabilities as a population experiencing health disparities, which will help ensure that people with disabilities are represented in research funded by the National Institutes. Also in September of 2023, the Biden Administration proposed a new rule that would update the requirements for nondiscrimination on the basis of disability. Among other changes, the proposed rule would codify the Olmstead court decision, which requires people with disabilities to be served in the most integrated setting that is appropriate. The new designation and proposed rule may reflect, in part, an increased awareness of the challenges and health disparities faced by people with disabilities, many of which were exacerbated by the COVID-19 pandemic and its aftermath.
    In this analysis, KFF examines the characteristics of people with disabilities who are living in the community from the American Community Survey.

  • Who Uses Medicaid Long-Term Services and Supports?

    Issue Brief

    This analysis examines the characteristics of Medicaid enrollees who use Medicaid long-term services and supports (LTSS), how enrollees who use LTSS differ from those who do not use these services, and how enrollees who use different types of LTSS differ from each other.

  • The Burden of Medical Debt in the United States

    Issue Brief

    This analysis uses government data to examine the burden of medical debt, including variations based on state, age, race and ethnicity, and health status. It estimates that people in the United States owe at least $220 billion in medical debt.