Medicaid’s Future

Section 1115 demonstration waivers provide states an avenue to test new approaches in Medicaid and generally reflect changing priorities from one presidential administration to another. This issue brief summarizes waiver priorities and actions under the Biden Administration as well as pending waiver themes and other issues to watch. If the Build Back Better Act (BBBA) fails to pass or is narrowed significantly, Medicaid waivers and other administrative actions may be a key tool for the Biden Administration to advance policy priorities absent legislation.

As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.

The COVID-19 pandemic has magnified pre-existing health disparities for justice-involved populations, with coronavirus infection rates among incarcerated populations higher than overall infection rates in nearly all states. Justice-involved individuals are disproportionately low-income and often have complex and/or chronic conditions, including behavioral health needs. Although the statutory inmate exclusion policy prohibits Medicaid from covering services provided during incarceration (except for inpatient services), states may take other steps to leverage Medicaid to improve continuity of care for justice-involved individuals.

On KFF’s 21st annual Medicaid budget survey, all responding states reported at least one initiative to expand behavioral health care in Medicaid, including crisis service and other benefit expansions, initiatives to expand telehealth and address equity, and managed care changes.

The Build Back Better (BBB) Act proposes reducing disproportionate share hospital (DSH) allotments by 12.5% starting in federal fiscal year (FFY) 2023 and places limits on Medicaid uncompensated care (UCC) pools for non-expansion states. This policy watch explains what these payments are, what changes have been tied to the ACA, and examines potential implications of changes included in the BBB.

Recent policy attention has focused on closing the coverage gap for roughly 2.2 million individuals living in the 12 states that have not adopted Medicaid expansion included in the Affordable Care Act (ACA). These individuals do not qualify for Medicaid and have incomes below poverty, making them ineligible for premium subsidies in the…

More than 18 months into the COVID-19 pandemic, state Medicaid programs around the country continue to reshape policy in response to the public health emergency and at the same time advance broader initiatives and priorities, including efforts to address the social determinants of health and health equity, finds a new…

This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 21st annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report highlights policies in place in state Medicaid programs in FY 2021, particularly those related to the COVID-19 pandemic, as well as policy changes implemented or planned for FY 2022.

This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2021 and 2022. Findings are based on data provided by state Medicaid directors as part of the 21st annual survey of Medicaid directors in states and the District of Columbia conducted by KFF and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth.

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…