The Trump administration has signaled a willingness to allow states to use Section 1115 waiver authority to reshape Medicaid, with some states seeking waiver provisions such as work requirements, eligibility time limits, and premiums with disenrollment for non-payment for traditional Medicaid populations. The administration has placed a special emphasis on work requirements. In another area, continuing efforts to combat the opioid epidemic have focused policymakers’ attention on Medicaid’s role in the fight. And although President Donald Trump and Republicans in Congress in 2017 unsuccessfully sought to repeal and replace the Affordable Care Act and switch Medicaid to a system of per capita cap financing, there remains the possibility that they could rekindle their efforts to achieve these goals.
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Medicaid State Fact Sheets

What percentage of people are covered by Medicaid in your state? Our State Medicaid fact sheets provide a snapshot with key data for Medicaid in every state related to current coverage, access, and financing, as well as a politics section for each state.

The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review

This issue brief summarizes findings from 404 studies of the impact of state Medicaid expansions under the ACA published between January 2014 (when the coverage provisions of the ACA went into effect) and January 2020. It includes studies, analyses, and reports published by government, research, and policy organizations using data from 2014 or later. This body of research suggests that the expansion presents an opportunity for gains in coverage, improvements in access and financial security, and economic benefits for states and providers.

Medicaid Work Requirements and People with HIV

This data note examines the potential implications of work requirements for people with HIV, a population that relies heavily on Medicaid and for whom there are important clinical and public health reasons for maintaining consistent access to insurance coverage and HIV care.

Medicaid’s Future

The Trump administration has signaled a willingness to allow states to use Section 1115 waiver authority to reshape Medicaid, with some states seeking waiver provisions such as work requirements, eligibility time limits, and premiums with disenrollment for non-payment for traditional Medicaid populations. The administration has placed a special emphasis on…

Medicaid: What to Watch in 2020

Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Key Medicaid issues to watch in 2020 include: Medicaid expansion developments; Section 1115 waiver activity; enrollment and spending trends; benefits, payment and delivery system reforms, and the implications of the 2020 elections.

Supporting Work without the Requirement: State and Managed Care Initiatives

The Centers for Medicare and Medicaid Services (CMS) continues to promote state adoption of work and reporting requirements as a condition of Medicaid eligibility for certain nonelderly adults, although several such waivers have been set aside by federal courts. While most Medicaid adults are already working, some states and health plans have developed voluntary work support programs for nonelderly adults who qualify for Medicaid through non-disability pathways. These programs offer services that support work without conditioning Medicaid eligibility on having a job. This brief examines opportunities for and limitations on federal and state support of such programs, highlights several state and health plan initiatives, and explores their common themes.

From Ballot Initiative to Waivers: What is the Status of Medicaid Expansion in Utah?

The Utah legislature significantly changed and limited the Medicaid coverage expansion that was adopted by the voters through a ballot initiative in November 2018. This issue brief explains new provisions in Utah’s recently amended Section 1115 Medicaid waiver and the additional amendments that the state has submitted to CMS, including most recently a request for enhanced ACA federal matching funds for an expansion to 138% FPL with an enrollment cap.