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  • 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.

  • Medicaid Home & Community-Based Services: People Served and Spending During COVID-19

    Issue Brief

    This issue brief presents FY 2020 state-level data on the number of people receiving Medicaid HCBS and HCBS spending. This is the latest data available, and the first since the onset of the COVID-19 pandemic. The data were collected in KFF’s 19th survey of state officials administering Medicaid HCBS programs in all 50 states and DC. A related brief presents the latest data and highlights themes in key state policy choices about optional HCBS.

  • Medicaid’s Role for Dual-Eligible Beneficiaries

    Issue Brief

    This brief examines the role of Medicaid in providing health coverage to the 9.6 million Medicare beneficiaries who are also eligible for Medicaid. The brief explains the role Medicaid plays in providing supplemental coverage to fill in the gaps in Medicare’s coverage for these dual-eligible beneficiaries.

  • 5 Key Facts About Medicaid Eligibility for Seniors and People with Disabilities

    Issue Brief

    Nearly 1 in 4 Medicaid enrollees are eligible for the program because they are ages 65 and older or have a disability, and they have higher per-enrollee costs than other enrollees. Proposals to limit federal spending on Medicaid may create incentives for states to drop or reduce their eligibility or coverage for seniors and people with disabilities in response to fewer federal revenues. Considering the proposed reductions in Medicaid spending, this issue brief describes Medicaid eligibility pathways, enrollment, and spending among people eligible through the age and disability-related pathways.

  • Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    Medicaid's Role for Low-Income Medicare Beneficiaries An overview that identifies low-income Medicare beneficiaries (dual eligibles), how Medicaid can provide care for them, and the challenges to accessing care.

  • Medicare Chartbook

    Report

    The Medicare Chartbook includes data and background information critical to understanding the Medicare program and the challenges it faces in keeping up with the rising costs of health care and in ensuring the program s future financial security.