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  • Implications of CMS’s New “Healthy Adult Opportunity” Demonstrations for Medicaid

    Issue Brief

    On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to Medicaid eligibility, benefits, delivery systems, and program oversight. In exchange, states would agree to a limit on federal financing in the form of a per capita or aggregate cap. States that opt for the aggregate cap and meet performance standards could access a portion of federal savings if actual spending is under the cap. This issue brief explains the key elements of the HAO guidance and considers the implications of the new demonstrations.

  • White House Releases FY21 Budget Request

    Fact Sheet

    The White House released its FY 2021 budget request to Congress on February 10, 2020, which includes significant cuts to global health programs compared to the FY 2020 enacted levels. In addition, in some cases, these cuts are steeper than those proposed by the Administration in last year’s request.

  • Why it Matters: Tennessee’s Medicaid Block Grant Waiver Proposal

    Issue Brief

    On November 20, 2019, Tennessee submitted an amendment to its longstanding Section 1115 Waiver that would make major financing and administrative changes to its Medicaid program. The Centers for Medicare and Medicaid Services (CMS) certified the waiver as complete and opened a federal public comment period through December 27, 2019. Most significantly, Tennessee is requesting to receive federal funds in the form of a “modified block grant” and to retain half of any federal “savings” achieved under the block grant demonstration. This brief provides a high-level overview of the proposed waiver changes and context for why these changes matter.

  • What You Need to Know About the Medicaid Fiscal Accountability Rule (MFAR)

    Issue Brief

    On November 18, 2019, the Trump Administration released a proposed rule called the Medicaid Fiscal Accountability Regulation (MFAR). This brief provides some context on Medicaid financing, an overview of current state payment and financing rules, the provisions in the rule and potential implications for considerations.

  • 3 Takeaways From the Medicare Trustees Report

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman dives into this week’s release of the Social Security and Medicare Trustees Report to discuss the good news that may have been missed.