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  • A Guide to the Lawsuit Challenging CMS’s Approval of the Kentucky HEALTH Medicaid Waiver

    Issue Brief

    On January 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a State Medicaid Director letter announcing a new policy that, for the 1st time, allows states to condition Medicaid on participation in a work or “community engagement” program. The next day, CMS approved a new Medicaid waiver in Kentucky. The waiver includes a program called Kentucky HEALTH, which encompasses a work requirement as well as coverage lockouts of up to 6 months…

  • Medicaid’s Role for Children with Special Health Care Needs: A Look at Eligibility, Services, and Spending

    Issue Brief

    This issue brief describes the role that Medicaid plays for children with special health care needs. It explains common eligibility pathways, covered services, and program spending for these children. The Appendix includes 50-state data on the number of children with special health care needs covered by Medicaid/CHIP. A companion brief compares key characteristics of Medicaid/CHIP children with special health care needs to those covered by private insurance.

  • Medicaid’s Role for Medicare Beneficiaries

    Issue Brief

    This brief outlines Medicaid's role for Medicare beneficiaries. It describes the role that Medicaid plays for 10 million Medicare beneficiaries to help inform upcoming debates about proposals to restructure Medicaid financing in ways that could reduce federal funding.

  • Understanding Medicaid Ex Parte Renewals During the Unwinding

    Policy Watch

    As states unwind the Medicaid continuous enrollment provision, they must comply with federal renewal requirements, including the requirement to conduct ex parte, or automated renewals. This policy watch explains what ex parte renewals are, examines variation in ex parte renewal rates across states, and discusses current issues as well as actions states are taking to increase ex parte rates.

  • Six Months into the Medicaid Unwinding: What Do the Data Show and What Questions Remain?

    Policy Watch

    Six months into the unwinding of the Medicaid continuous enrollment provision, KFF tracking shows states are reporting outcomes for over 28 million renewals, accounting for three in ten people who were enrolled as of March 2023 when continuous enrollment ended. This policy watch examines the latest data and key questions as the unwinding continues to unfold.

  • Medicaid Enrollment Churn and Implications for Continuous Coverage Policies

    Issue Brief

    Recent policy actions and proposals in Medicaid have renewed focus on the problem of churn, or temporary loss of coverage in which enrollees disenroll and then re-enroll within a short period of time. We find that 10% of full-benefit enrollees have a gap in coverage of less than a year, and rates are higher for children and adults compared to aged and people with disabilities. Churn has implications for access to care as well as…

  • Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience

    Policy Watch

    On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of…

  • What Are the Primary Medicaid Eligibility Pathways for Dual-Eligible Individuals?

    Issue Brief

    This brief examines current Medicaid eligibility policies and enrollment patterns using data from KFF’s 2024 50-state survey of states’ eligibility and enrollment policies for seniors and people with disabilities, and 2021 Medicare and Medicaid claims data from the Centers for Medicare and Medicaid Services (CMS).