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  • States Getting a Jump Start on Health Reform’s Medicaid Expansion

    Issue Brief

    One of the primary goals of the Affordable Care Act (ACA) is to decrease the number of uninsured through a Medicaid expansion to nearly all individuals with incomes up to 133 percent of the federal poverty level (FPL) ($14,856 for an individual or $25,390 for a family of three in 2012) and the creation of new health insurance exchanges. These coverage expansions, which will take effect in 2014, will eventually cover about 32 million uninsured…

  • Governors’ Budgets for FY 2013 — What is Proposed for Medicaid?

    Issue Brief

    This report provides Medicaid highlights from governors' proposed state budgets for FY 2013, which starts July 1, 2012 for most states. While some states are beginning to see signs of economic recovery, many remain cautiously optimistic as they continue to experience the recession's lingering effects. State revenues have not rebounded to pre-recession levels, unemployment rates are still high, and some states continue to face budget shortfalls. There continues to be high demand for Medicaid and…

  • Essential Health Benefits: Balancing Affordability and Adequacy

    Event Date:
    Event

    Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets - will be required to cover a set of health benefits and services called the "essential health benefits" package. Guidance issued last month by the Department of Health and Human Services will give each state some discretion to specify benefits package raises many questions. What is…

  • Medicaid and Managed Care: Key Data, Trends, and Issues

    Issue Brief

    This brief provides a snapshot of the Medicaid program's use of managed care to deliver services to beneficiaries. It examines the prevalence of managed care in state Medicaid programs; the various approaches states have used, including primary-care case management; managed care for long-term services and for beneficiaries dually eligible for Medicaid and Medicare; and evidence of cost-savings.   ISSUE BRIEF Download

  • Medicaid Enrollment and Expenditures by Federal Core Requirements and State Options

    Issue Brief

    To receive federal Medicaid matching funds, states that participate in Medicaid must meet federal requirements, which include covering specified “federal core” enrollee groups and mandatory health benefits. States also may choose to cover additional “state expansion” enrollees and optional benefits with federal Medicaid matching funds. The federal core eligibility standards have expanded incrementally over time, mostly for children and pregnant women, as the Medicaid program separated from welfare. Moreover, many states have taken up options…

  • Impact of the Medicaid Fiscal Relief Provisions in the American Recovery and Reinvestment Act (ARRA)

    Issue Brief

    The American Recovery and Reinvestment Act (ARRA), enacted in February 2009, has provided $103 billion in federal fiscal relief to state Medicaid programs over a period of two-and-a-half years to help them address the effects of the 2007-2009 recession. During a recession, unemployment increases and state revenues decline, making it difficult for states to meet the increased demand for Medicaid coverage among the newly unemployed. This brief reviews the ARRA Medicaid fiscal relief provisions—how they…

  • Update: State Budgets in Recession and Recovery

    Issue Brief

    State revenues have been rebounding after experiencing a severe decline caused by the Great Recession that ran from December 2007 through June 2009. Nevertheless, tax collections remain below their 2008 peak level and state and local governments continue to shed jobs. As states prepare their fiscal year 2013 budgets, some are projecting a fifth consecutive year of gaps between expected revenues and spending. This policy brief analyzes recent developments in state government finances and prospects…

  • An Overview of Changes in the Federal Medical Assistance Percentages (FMAPs) for Medicaid

    Issue Brief

    The joint federal-state financing of the Medicaid program works through a matching mechanism known as the Federal Medical Assistance Percentage (FMAP). This mechanism determines the federal and state shares of Medicaid costs based on a state's per capita personal income relative to the national average. While the FMAP formula has remained unchanged since the enactment of the Medicaid program in 1965, changes in per capita income have resulted in substantial changes in the federal and…

  • Five Key Questions And Answers About Section 1115 Medicaid Waivers

    Issue Brief

    This issue brief provides an overview of what Section 1115 Medicaid waivers are, how they are approved and financed, how states have used them, and how they are impacted by health reform. For many years, Section 1115 waivers have been used by states to test new coverage approaches not otherwise allowed under Medicaid program rules. Some waivers have also raised important policy issues. Since the passage of the health reform law, several states, including California,…

  • Enhanced Medicaid Match Rates Expire in June 2011

    Fact Sheet

    This fact sheet discusses the role played by the enhanced federal Medicaid matching funds available to states through the American Recovery and Reinvestment Act of 2009 (ARRA), and the implications for state Medicaid programs as that extra assistance expires June 30, 2011. States used the ARRA enhanced Medicaid funding to address Medicaid funding shortfalls during the economic downturn, and to mitigate program cuts and address budget shortfalls. As national unemployment has increased in recent years…