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  • Medicaid and Children’s Health Insurance Program Provisions in the New Health Reform Law

    Issue Brief

    This brief compares the Medicaid and Children's Health Insurance Program provisions in the new health reform law with pre-reform law governing those programs. The analysis focuses on Medicaid coverage and financing changes; how Medicaid and CHIP will interface with a new health insurance exchange and other Medicaid benefits and access changes. Overall, the new law includes an individual requirement to obtain health insurance, a significant Medicaid expansion and subsidies to help low-income individuals buy coverage…

  • Medicare Prescription Drug Plans In 2010 and Key Changes Over Five Years

    Issue Brief

    This brief summarizes key findings from the full collection of 2010 Part D Data Spotlights examining key trends in the private stand-alone drug plans available to Medicare beneficiaries. The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. The analysis was conducted jointed by Jack Hoadley and Laura Summer of Georgetown University, Elizabeth Hargrave of NORC at the University of Chicago,…

  • Medicaid and Long-Term Care: Recent Publications Illuminate Key Policy Issues

    Fact Sheet

    With recent policy debates about the future of Medicaid, the Foundation's Kaiser Commission on Medicaid and the Uninsured has created a resource page of recent publications that address key policy issues when examining Medicaid's role for high cost populations and in long-term care. Of particular interest are a report profiling six Medicaid populations with serious health needs resulting in high costs for the program and a recent analysis showing more than half (52%) of Medicaid…

  • The Impact of Part D on Dual Eligibles Who Spend-Down to Medicaid

    Issue Brief

    Individuals with incomes exceeding thresholds for regular Medicaid eligibility may qualify under state medically needy programs by spending down excess income on healthcare services. For the vulnerable population of Medicare beneficiaries who spend down to Medicaid, the Part D transition has added additional complexities that may result in disruptions in pharmacy coverage and add financial burdens. This paper explores the inter-relationship of Medicare prescription drug coverage and Medicaid spend-down for the medically needy. It describes…

  • Money Follows the Person: An Early Implementation Snapshot

    Issue Brief

    This issue brief examines the early successes and challenges of the Money Follows the Person Demonstration (MFP), a Medicaid initiative enacted into law in 2006 that gives states enhanced federal support to balance their Medicaid long-term care programs by providing more services in the community and fewer in institutional settings. A 2008 Kaiser Commission on Medicaid and the Uninsured survey of 29 states receiving MFP grants turned up several key findings, including that several hundred…

  • Medicare Part D 2010 Data Spotlight: The Coverage Gap

    Report

    This data spotlight examines the coverage gap, or "doughnut hole," in Medicare stand-alone drug plans available in 2010. While in the gap in coverage, Part D enrollees (other than those receiving low-income subsidies) are required to pay 100 percent of total drug costs until they reach the catastrophic coverage level. In 2010, nearly all the private stand-alone drug plans have a coverage gap, though a small share do provide some help to beneficiaries in the…

  • The Role of National Firms in Medicare+Choice

    Report

    This report addresses national managed care firms participation in M+C and the factors influencing their decision processes about M+C products. Based on interviews with executives and senior staff of national managed care firms, this report examines how eight national firms strategically position their M+C product, including the process that firms use when making decisions and the key factors they say most influence their decisions related to participation. Report

  • State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

    Report

    The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of these models. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…

  • The Implications of the Medicare Prescription Drug Benefit for Dual Eligibles

    Other Post

    Three new reports focus on one of the biggest challenges in the implementation of the Medicare Modernization Act, the transitioning of drug coverage for individuals dually eligible for Medicaid and Medicare, who now get their drug coverage from Medicaid, to the new Medicare benefit. The New Medicare Prescription Drug Law: Issues for Enrolling Dual Eligibles into Drug Plans Medicare's New Prescription Drug Benefit: The Voices of People Dually Covered by Medicare and Medicaid Implications of…