A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes
This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.
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State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes
News ReleaseAs states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.
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Prior Authorization Process Policies in Medicaid Managed Care: Findings from a Survey of State Medicaid Programs
Issue BriefThis brief examines state policies related to prior authorization processes in Medicaid managed care and includes findings about how states approach prior authorization decision timeframes, electronic denial notices, and access to external medical reviews, all as of July 1, 2024.
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A Backlash Against Health Insurers, Redux
PerspectiveIn this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.
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10 Things to Know About Medicaid Managed Care
Issue BriefOur updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
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What is Medicaid Home Care (HCBS)?
Issue BriefThis issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.
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A Look at Medicaid Enrollment and Finances of the Five Largest Medicaid Managed Care Plans
Issue BriefThis brief examines enrollment and financial data through the end of September 2024 from quarterly company earnings reports and calls, financial filings, and other company materials as well as from national administrative data.
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The Semi-Sad State of Consumer Protection In Health Care
From Drew AltmanIn this column, KFF President and CEO Drew Altman explores the state of consumer protections in health care and explains why, even with consumer frustration clear, Congress is unlikely to pursue major new health insurance protections but there could be some modest steps.