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The White House released its FY 2019 budget request to Congress on February 12, 2018, which includes significant cuts to global health programs compared to FY 2017 enacted levels (the overall levels in the request are similar to the FY 2018 budget request).
This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2017 and 2018. Findings are based on interviews and data provided by state Medicaid directors as part of the 17th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) survey and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth.
Medicaid enrollment growth slowed to 2.7 percent in state fiscal year 2017, down from 3.9 percent the prior year and far off the peak of 13.2 percent in 2015 that followed implementation of the Affordable Care Act’s (ACA) Medicaid expansion, according to a new survey from the Kaiser Family Foundation.
This report provides Medicaid highlights from governors’ proposed budgets for state fiscal year (FY) 2018, which runs from July 1, 2017 through June 30, 2018 in most states. Proposed budgets reflect the priorities of the governor and are often blueprints for the legislature to consider.
This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 19th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report highlights certain policies in place in state Medicaid programs in FY 2019 and policy changes implemented or planned for FY 2020.
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.
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.
The Kaiser Family Foundation has launched a new interactive tool designed to provide the latest data on the U.S. government's global health budget in an easy-to-access form. The U.S. Global Health Budget Tracker lets users follow the budget from the President's budget request through the appropriations process in Congress, as well as see trends over time.
The Kaiser Family Foundation hosted a town hall forum with Ambassador Deborah L. Birx, M.D. the new U.S. Global AIDS Coordinator, in which she shared her vision for the next phase of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in supporting efforts to achieve an AIDS-free generation.
The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) released its 15th annual 50-state Medicaid budget survey for state fiscal years 2015 and 2016. Kaiser and the National Association of Medicaid Directors (NAMD) held a joint briefing to discuss key findings and highlight trends in enrollment and spending as well as policy changes in Medicaid programs around the country.
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