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The Trump administration has signaled a willingness to allow states to use Section 1115 waiver authority to reshape Medicaid, with two dozen states seeking waiver provisions such as work requirements, drug screening and testing, 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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Public More Likely To Trust Democratic Party To Do A Better Job Dealing With Most Health Care Issues

A new analysis featuring data from the KFF Election Tracking Poll released in October 2018 finds that the public trusts the Democratic Party more than the Republican Party when it comes to dealing with health care issues, such as increasing women’s access to reproductive services, maintaining Medicaid expansion, and maintaining protections for pre-existing conditions.

KFF Election Tracking Poll: Health Care in the 2018 Midterms

In an expansive look at the 2018 midterm elections, this month’s KFF Health Tracking Poll includes an in-depth examination of the role health care may be playing in midterm elections nationally, as well as in Florida and Nevada, two bellwether states in which candidates from both parties are talking about health care issues. Health care remains a top priority for Democrats and independents, but ranks lower for Republicans, behind immigration and the economy and jobs. However, when it comes to specific health care issues, lowering health care costs and maintaining protections for pre-existing conditions have bipartisan support. In addition to exploring the role of health care issues in the election, the KFF Health Tracking Poll also finds large shares of voters say candidate characteristics, President Trump, and party control over Congress will be major factors in their voting decisions.

Federal Legislation Related to Medicaid and Opioids: What to Watch

With President Trump having declared the opioid epidemic a public health emergency, both the House and Senate are advancing legislation to address the crisis. A new issue brief from the Kaiser Family Foundation summarizes current federal legislative proposals related to Medicaid’s role in the opioid epidemic and identifies issues to…

Key Questions about Medicaid Payment for Services in “Institutions for Mental Disease”

With the opioid epidemic continuing, state interest in expanding access to substance use disorder (SUD) services remains high. Medicaid financed 21% of SUD services and 25% of mental health services in 2014. Section 1115 waivers related to behavioral health remain the most frequent type of waiver sought and obtained by states, with most requesting authority to use federal Medicaid funds for services provided in “institutions for mental disease” (IMDs). Since Medicaid’s inception, Congress has prohibited states from using Medicaid funds for IMD services for non-elderly adults. This brief provides new data and answers key questions about the Medicaid IMD payment exclusion as waiver activity continues, and Congress considers legislative changes, including a House bill that would restrict IMD SUD services to those with opioid use disorder, excluding those with other SUDs.

Texas Residents’ Views on State and National Health Policy Priorities

As part of the new Kaiser Family Foundation/Episcopal Health Foundation 2018 Texas Health Policy Survey, this brief explores Texans’ views on health policy priorities at both the state and national level. It examines how Texas residents view state spending on health care and how they rank initiatives such as lowering health care costs, reducing maternal mortality, and funding for mental health care. It also explores Texans’ views on the Affordable Care Act and Medicaid, including personal connections to the Medicaid program and support for Medicaid expansion.

Implications of the ACA Medicaid Expansion: A Look at the Data and Evidence

More than four years after the implementation of the Medicaid expansion included in the Affordable Care Act, debate and controversy around the implications of the expansion continue. Despite a large body of research that shows that the Medicaid expansion results in gains in coverage, improvements in access and financial security, and economic benefits for states and providers, some argue that the Medicaid expansion has broadened the program beyond its original intent diverting spending from the “truly needy”, offers poor quality and limited access to providers, and has increased state costs. New proposals allow states to implement policies never approved before including conditioning Medicaid eligibility on work or community engagement. New complex requirements run counter to the post-ACA movement of Medicaid integration with other health programs and streamlined enrollment processes. This brief examines evidence of the effects of the Medicaid expansion and some changes being implemented through waivers. Many of the findings on the effects of expansion cited in this brief are drawn from the 202 studies included in our comprehensive literature review that includes additional citations on coverage, access, and economic effects of the Medicaid expansion.

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

This issue brief summarizes findings from 202 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 February 2018. 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.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.