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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Explaining Texas v. U.S.: A Guide to the Case Challenging the ACA

The Affordable Care Act’s (ACA) future continues to be uncertain as Texas v. U.S. (known as California v. Texas in the U.S. Supreme Court), remains unresolved. This issue brief answers key questions about the litigation as we await a decision from the Supreme Court about whether it will review the case.

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…

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.

Opioid Use Disorder among Medicaid Enrollees: Snapshot of the Epidemic and State Responses

As the largest payer of substance use disorder services in the United States, Medicaid plays a central role in state efforts to address the opioid epidemic. In addition to increasing access to addiction treatment services through the expansion of Medicaid under the Affordable Care Act (ACA), states are expanding Medicaid addiction treatment services, increasing provider reimbursements, restricting opioid prescribing, and implementing delivery system reforms to improve the quality of treatment services. While many states have been tracking progress and challenges in these efforts, uniqueness of state systems can make it difficult to compare or benchmark across states. This brief draws on analyses provided by the Medicaid Outcomes Distributed Research Network (MODRN), a collaborative effort to analyze data across multiple states to facilitate learning among Medicaid agencies. It profiles the opioid epidemic among the Medicaid population in six states participating in MODRN that also have been hard hit by the opioid epidemic: Kentucky, Maryland, Ohio, Pennsylvania, Virginia, and West Virginia. The brief also draws on interviews with officials from the state Medicaid and other health agencies.

Medicaid Spending, Enrollment and Policy Trends: A View from the States

On Friday, Oct. 18, KFF released its 19th annual 50-state Medicaid budget survey for state fiscal years 2019 and 2020. KFF and the National Association of Medicaid Directors (NAMD) held a joint briefing to discuss trends in enrollment and spending and highlight key Medicaid policy developments.

A View from the States: Key Medicaid Policy Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2019 and 2020

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.

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.