The Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments
One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law's Medicaid expansion.
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One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law's Medicaid expansion.
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.
On January 22, 2018, Congress passed a six-year extension of CHIP funding as part of a broader continuing resolution to fund the federal government. Federal funding for CHIP had expired on September 30, 2017. Without additional funding available, states operated their CHIP programs using remaining funds from previous years. However, some states came close to exhausting funding, leading them to make contingency plans to reduce coverage and notify families of potential coverage reductions. In late December 2017, Congress provided some short-term funding for early 2018, but some states still expected to exhaust funds by March 2018. The six-year funding extension provides stable funding for states to continue their CHIP coverage. This fact sheet provides a summary of key provisions of the CHIP funding extension.
Most of the states with approved or pending Section 1115 waivers that condition Medicaid eligibility on work would apply those requirements to all or most nonelderly adults (ages 19-64) who are not receiving Supplemental Security Income (SSI) cash assistance, including older nonelderly adults (ages 50-64). Older nonelderly adults may be limited in their ability to satisfy a work requirement due to barriers resulting from age and/or disability. Previous analysis shows that many nonelderly Medicaid adults (ages 19-64) have functional limitations that may interfere with their ability to work but do not rise to the stringent SSI level of disability, making them potentially subject to work requirements. Older nonelderly adults are over twice as likely to have a disability than younger adults (17% vs. 7%). Furthermore, older nonelderly adults account for nearly half (45%) of all nonelderly Medicaid adults with a disability but not SSI who could be affected by a work requirement. This analysis examines the implications of work requirements for Medicaid adults ages 50 to 64 (referred to as “older nonelderly Medicaid adults”) and provides national and state level estimates of their disability, SSI, and work status using data from the 2016 American Community Survey (ACS).
State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people with behavioral health needs, and financing delivery system reforms.
This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.
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.” As with broader Medicaid policy, the future landscape of Section 1115 waivers depends on the outcome of the November 2024 presidential election as a new administration could focus on different priorities, rescind existing guidance, or withdraw already-approved waivers. This waiver watch summarizes five key areas of difference in 1115 waiver policy and waiver approvals under the Trump and Biden-Harris administrations.
With some states grappling over whether to expand Medicaid, and Congress facing big decisions about the future of the Children's Health Insurance Program (CHIP), this briefing reviewed the basics about both programs, and discuss current issues. Co-hosted by the Kaiser Family Foundation and the Alliance for Health Reform, KFF's Diane Rowland and Ed Howard of the Alliance moderated the discussion.
Medicaid is an important source of health insurance coverage for people with disabilities. This issue brief explains how Medicaid eligibility and benefits for people with disabilities are affected by the Affordable Care Act (ACA) rules as of 2014. Marketplace rules are discussed to the extent that they relate to Medicaid eligibility determinations for people with disabilities.
Several major deficit-reduction and entitlement reform proposals include raising Medicare's age of eligibility from 65 to 67 as a way of improving Medicare's solvency.
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