Medicaid’s Future

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…

This issue brief describes key characteristics of SSI enrollees, explains the SSI eligibility criteria and eligibility determination process, and considers the implications of changes in the SSI program for Medicaid, including the effects of the COVID-19 pandemic and resulting economic downturn as well as proposals supported by President Biden that Congress might consider.

On June 23, 2021, a circuit court decision in Missouri put the state’s expansion of Medicaid under the Affordable Care Act (ACA) in limbo. This decision, if upheld, has implications for coverage in the state as well as the availability of federal financing to cover the cost.

Our review of recent literature on premiums and cost-sharing is based on studies and reports published between 2017 and 2021. Our analysis of premiums in post-Affordable Care Act (ACA) Section 1115 waivers (approved under the Obama and Trump administrations) is based on available interim and final waiver evaluations as well as annual and quarterly state data reports posted on Medicaid.gov.

This issue brief provides context for ongoing policy discussions by describing key characteristics of children with special health care needs, comparing insurance affordability and access to key benefits among those covered by Medicaid/CHIP and those with private insurance, and considering the implications of additional Medicaid HCBS funding for children with special health care needs.

This literature review report summarizes evidence from nearly 200 studies on the effects of Medicaid expansion published between February 2020 and March 2021. These studies generally find beneficial impacts of expansion across a range of areas.

New federal financial incentives for Medicaid expansion and the increased reliance on Medicaid as a coverage safety net during the pandemic have renewed debate in the 12 states that have not adopted the Medicaid expansion under the Affordable Care Act. A new KFF literature review provides context for these expansion…

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 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.

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.