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  • Medicaid’s Role for Selected Populations

    Feature

    Medicaid_s role for selected populations Download Source NOTE: FPL-- Federal Poverty Level. The U.S. Census Bureau's poverty threshold for a family with two adults and one child was $19,318 in 2016. SOURCES: KFF analysis of 2017 Current Population Survey, Annual Social and Economic Supplement; Birth data -Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017, KFF, October 2016.; Medicare data - Medicare Payment Advisory Commission,…

  • An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity

    Issue Brief

    This brief summarizes and examines the implications of recent Section 1115 Medicaid waiver activity. Section 1115 waivers provide states flexibility to test new approaches in Medicaid that differ from federal program rules and can have significant impacts for beneficiaries, providers, and states. While recent waivers and waiver proposals vary in their specific goals and approaches, some key themes are emerging, including using Section 1115 waiver authority to get a jump start on the 2014 Medicaid…

  • Emerging Medicaid Accountable Care Organizations: The Role of Managed Care

    Issue Brief

    This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs. An ACO is a provider-run organization in which participating providers are collectively responsible for the care of an enrolled population, and may share in any savings associated with improvements in the quality and efficiency of care. The structure of Medicaid ACO initiatives is influenced by individual states’ experience with managed care, other existing care delivery…

  • Olmstead: I Did It

    Video

    This Kaiser Commission on Medicaid and the Uninsured video segment returns to the plaintiffs of the Olmstead case five years after the landmark U.S. Supreme Court decision. It reports on the impact of the decision for individuals with disabilities and some of the challenges that remain in the implementation of the court ruling.

  • Medicaid Long-Term Services and Supports: Key Considerations for Successful Transitions from Fee-For-Service to Capitated Managed Care Programs

    Issue Brief

    Although relatively few Medicaid beneficiaries are in capitated managed long-term services and supports (LTSS) programs, significant expansion is anticipated as more than half of states are implementing or proposing new programs that would include a transition from fee-for-service (FFS) to capitated managed care in the LTSS delivery system. By definition, these Medicaid beneficiaries need assistance with activities of daily living. Thus poor transitions, particularly those that lead to gaps in services, can have dire consequences.…

  • The Intersection of Medicaid, Special Education Service Delivery, and the COVID-19 Pandemic

    Issue Brief

    The COVID-19 pandemic created unprecedented health and education challenges for children with disabilities, many of whom receive special education services. Many children receiving special education services have substantial health care needs, and services available through a child’s health insurance plan, such as Medicaid, can complement special education services. This brief explains how Medicaid and special education services intersect, explores the pandemic’s implications for children receiving special education services, and identifies key issues to watch moving…

  • A View from the States: Key Medicaid Policy Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2019 and 2020

    Report

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 19th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report highlights certain policies in place in state Medicaid programs in FY 2019…

  • 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.

  • New Analysis of Historical Rates of Medicaid Enrollment Churn Sheds Light on the Implications for the End of the Continuous Enrollment Requirement Tied to Pandemic Funding

    News Release

    For more than a year-and-a-half, the continuous enrollment requirement tied to enhanced Medicaid funding during the COVID-19 pandemic has all but halted enrollment “churn,” the temporary loss of coverage in which people disenroll from Medicaid and then re-enroll within a short period of time. Such disenrollments are expected to resume once the requirement ends and states begin processing Medicaid eligibility redeterminations. Individuals may lose coverage if they are no longer eligible or face barriers during…

  • Analysis Examines Insurance Coverage, Affordability and Access to Home and Community-Based Services for Children with Special Health Care Needs

    News Release

    A new KFF analysis examines key characteristics of children with special health care needs, the affordability and adequacy of their health coverage, and the implications for such children of potential new federal Medicaid money to assist families in caring for them. Medicaid is a significant source of coverage for medical, behavioral health, and long-term services and supports for children with special health care needs, including home and community-based services (HCBS) that they need to live…