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  • Using Data and Technology to Drive Process Improvement in Medicaid and CHIP: Lessons From South Carolina

    Fact Sheet

    In the past year, there has been a notable trend of states increasingly utilizing data and technology to modernize, streamline, and gain efficiencies in their Medicaid and CHIP programs. The expanded use of data and technology is not only helping states deal with current budget pressures and decreased administrative resources, but also lays important groundwork for the coverage expansions and new coordinated, streamlined, and technology-driven enrollment process that will go into effect in 2014 under…

  • The Medicaid Medically Needy Program: Spending and Enrollment Update

    Issue Brief

    This brief examines Medicaid's medically needy program, which gives states the option to extend Medicaid eligibility to those with high medical expenses whose income exceeds the maximum threshold, but who would otherwise qualify. It provides updated enrollment and spending figures on the medically needy using data through federal fiscal year 2009, and explains how individuals become eligible for the program and key considerations for policy discussions. Brief (.pdf)

  • Visualizing Health Policy: Eligibility and Coverage Trends in Employer-Sponsored Health Insurance

    Other Post

    This Visualizing Health Policy infographic looks at eligibility and coverage trends in employer-sponsored health insurance. Between 2000 and 2015, the share of workers covered by health benefits offered by their employers dropped from 63 percent to 56 percent, with some firms not offering coverage and some employees not enrolling when coverage is offered. The biggest decrease occurred among employees working for small firms (3-199 workers). Among people younger than 65, those with lower incomes continued to…

  • Don’t Expect Medicaid Work Requirements to Make a Big Difference

    From Drew Altman

    Under the Trump Administration, some Republican governors may look to move their Medicaid programs in a more conservative direction. In his latest column for Axios, Drew Altman discusses the arguments about Medicaid “work requirements” and why few people are likely to be affected by them in practice.

  • 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…

  • State Medicaid Eligibility Policies for Individuals Moving Into and Out of Incarceration

    Issue Brief

    This brief highlights how state eligibility policies for incarcerated individuals differ, based on a review of state statutes, regulations, Medicaid eligibility manuals and other Medicaid agency guidance publicly available online and Medicaid managed care contracts. Overall, state Medicaid eligibility policies for justice-involved individuals moving into and out of incarceration vary, and these policies affect if and when individuals may enroll in Medicaid and the scope of any resulting savings.

  • February State Data for Medicaid Work Requirements in Arkansas

    Issue Brief

    Arkansas is one of seven states for which CMS has approved a Section 1115 waiver to condition Medicaid eligibility on meeting work and reporting requirements and the first state to implement this type of waiver. The new requirements were phased in for most enrollees ages 30-49 beginning in June 2018, and for individuals ages 19-29 starting in January 2019. Unless exempt, enrollees must engage in 80 hours of work or other qualifying activities each month…

  • A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community

    Issue Brief

    The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care. The Affordable Care Act (ACA) provides incentives for…