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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.

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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.

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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.

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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.

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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.

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How Will Medicare-for-all Proposals Affect Medicaid?

As the debate over the future direction of our health care system heats up leading into the 2020 Presidential election, several Democratic proposals to create a single, federal, universal health insurance program known as Medicare-for-all have garnered significant attention. These proposals would replace most current public and private health insurance with a new federal program that would guarantee health coverage for all or nearly all U.S. residents. However, many details about how a new public program would be implemented and financed are not yet known. While much attention has focused on the implications of ending private insurance and Medicare, the debate has largely ignored the effects on the low-income and vulnerable populations covered by Medicaid and the broader implications for states of eliminating the Medicaid program.

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A Comprehensive Review of Research Finds That the ACA Medicaid Expansion Has Reduced the Uninsured Rate and Uncompensated Care Costs in Expansion States, While Increasing Affordability and Access to Care and Producing State Budget Savings   

 Multiple studies over the last five years find that the Affordable Care Act’s Medicaid expansion has increased health coverage, affordability, and access to care while producing budget savings for states and reductions in uncompensated care costs for hospitals and clinics, according to a KFF review of more than 300 studies…

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Explaining Texas v. U.S.: A Guide to the 5th Circuit Appeal in the Lawsuit Challenging the Affordable Care Act 

The outcome of the Texas v. U.S. legal challenge to the Affordable Care Act (ACA) could have far-reaching consequences for the nation’s health system, from rolling back the expansion of Medicaid to removing protections for people with pre-existing conditions and revoking the ability of adult children to stay on their…

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How Do Medicaid/CHIP Children with Special Health Care Needs Differ from Those with Private Insurance?

This issue brief compares the demographics, health status, access to care, and coverage affordability of Medicaid/CHIP children with special health care needs to those with private insurance and those who are uninsured. Medicaid plays a key role for children with special health care needs by making coverage affordable and covering services that private coverage typically does not. Consequently, legislative proposals that would cap and reduce federal Medicaid funding may pose a particular risk to children with special health care needs and their providers. A companion brief describes Medicaid’s role for children with special health care needs.

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Medicaid’s Role for Children with Special Health Care Needs: A Look at Eligibility, Services, and Spending

This issue brief describes the role that Medicaid plays for children with special health care needs. It explains common eligibility pathways, covered services, and program spending for these children. The Appendix includes 50-state data on the number of children with special health care needs covered by Medicaid/CHIP. A companion brief compares key characteristics of Medicaid/CHIP children with special health care needs to those covered by private insurance.

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