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This brief describes Medicaid’s role for nearly 7 million nonelderly adults with disabilities living in the community to help inform the debate about the American Health Care Act’s proposals to end enhanced federal funding under the ACA and reduce federal Medicaid funding under a per capita cap.
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…
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.
For 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed…
The Balancing Incentive Program provides enhanced federal matching funds, allowing states to advance their efforts to rebalance Medicaid long-term services and supports (LTSS) spending and expand access to home and community-based services as an alternative to institutional care. This report highlights participating states' efforts to implement the program's three structural requirements and use the enhanced federal funds in support of other Medicaid LTSS rebalancing efforts.
This issue brief places the American Jobs Plan in the context of current Medicaid HCBS spending and considers how policymakers might allocate the new funding, as the proposal to date includes little detail.
As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.
Distribution of Medicaid Beneficiaries Who Use Long-Term Services and Supports, by Dual Eligibility Status, FY 2010 Download Source KCMU and Urban Institute estimates based on FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 data. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.
Distribution of Medicaid Home and Community-Based Services Expenditures as a Share of Total Medicaid Long-Term Services and Supports Spending, FY 2011 Download Source Urban Institute estimates based on FY 2011 Centers for Medicare & Medicaid Services (CMS)-64 data.
Growth in Medicaid Long-Term Services and Supports Expenditures, FY 2002 – FY 2011 Download Source KCMU and Urban Institute analysis of Centers for Medicare & Medicaid Services (CMS)-64 data.
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