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The unwinding of pandemic enrollment protections in Medicaid helped accelerate states’ expansion of eligibility for key groups and adoption of policy and system changes to streamline renewal processes for enrollees, according to findings from a new KFF survey of state Medicaid officials.
On August 31, the Centers for Medicare and Medicaid released a proposed rule to create more uniform processes across states that will make it easier for eligible people to obtain and maintain coverage in Medicaid and the Children’s Health Insurance Program (CHIP).
This policy watch examines Mississippi's recent Medicaid expansion activity, what expansion could mean for residents and the economy, and key developments to watch.
KFF’s Survey of Medicaid Financial Eligibility for Older Adults & People with Disabilities, conducted in March 2025 by KFF and Watts Health Policy Consulting, provides a baseline of Medicaid eligibility as states return to normal operations after the end of the COVID-19 pandemic and ahead of potential changes to the Medicaid program.
Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, so long as the approach is likely to “promote the objectives of the Medicaid program.” Waivers generally reflect priorities identified by states as well as changing priorities from one presidential administration to another. The Biden administration encouraged states to propose waivers that expand coverage, reduce health disparities, advance whole-person care, and improve access to behavioral health care. Looking ahead, the new Trump administration’s waiver priorities will likely differ significantly from those of the Biden administration. However, it is unclear how the Trump administration will treat certain waivers promoted and approved by the Biden administration.
On Friday, Oct. 18, KFF released its 19th annual 50-state Medicaid budget survey for state fiscal years 2019 and 2020. KFF and the National Association of Medicaid Directors (NAMD) held a joint briefing to discuss trends in enrollment and spending and highlight key Medicaid policy developments.
Two initiatives that for years have helped shift Medicaid enrollees away from nursing homes in favor of long-term care at home and in the community face year-end deadlines that could undercut that trend, according to two new KFF issue briefs.
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.
This issue brief reviews accessibility of information for people with LEP and people with disabilities provided through state Medicaid websites and call center automated phone trees as of June 16, 2022. The analysis shows that while states have taken some steps to support access to information and applications for people with LEP and people with disabilities, gaps in accessibility remain.
This brief presents findings from a survey and roundtable discussion of Medicaid managed care plans about the role they may play in the unwinding of the pandemic-era continuous enrollment provision.
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