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Current law allows states to use revenue from provider taxes to help fund the state share of spending on Medicaid, a program that is jointly financed by the states and the federal government. Almost all states have at least one provider tax in place. This issue brief reviews the use of provider taxes by states as a mechanism for financing the state share of Medicaid spending. It also explores the implications of recent proposed changes…
Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with a focus on eligibility, benefits and cost sharing, care delivery and provider payment, long-term services and supports, and dual eligibles, as well as key issues…
This issue brief examines the broad implications of converting Medicaid to block grant financing, one of several ideas that have been put forth to help reduce the federal deficit. The paper, which does not analyze any specific proposal, notes that switching to block grant financing would fundamentally alter the Medicaid program and could have significant implications for states, localities, beneficiaries and health care providers. Issue Brief (.pdf) Related Resources: Prior Analyses of Block Grant Proposals…
This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending. Fact Sheet (.pdf)
This report examines Medicaid spending growth nationally during the last decade, with a focus on growth during the recession of 2007 to 2009. The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been…
This analysis examines the potential costs and savings that the health reform law may generate for state budgets, a topic of great interest at a time when states continue to struggle with tight budgets in the wake of the recession. The analysis seeks to explain why recent state estimates of the likely impact of health reform on their budgets vary widely, and discusses the major expected sources of costs and savings as the new law…
Three papers from the Foundation's Commission on Medicaid and the Uninsured examine Medicaid enrollment and spending during the recent recession. The analyses show Medicaid enrollment rose above 50 million people nationally for the first time in 2010, reflecting the program’s counter-cyclical role of helping people who become uninsured when the economy falters, with many turning to Medicaid after losing jobs and employer-based health insurance. Without access to Medicaid coverage, millions more people who suffered economic…
This report, based on structured discussions in November and December 2010 with leading Medicaid directors, augments the findings from the most recent comprehensive 50-state Medicaid budget survey to provide a mid-year 2011 update on state Medicaid issues. As they prepare their fiscal 2012 budgets, many states, some under new gubernatorial and legislative leadership, continue to cope with lingering effects of the worst recession in decades and are facing budget shortfalls, with revenues remaining below pre-recession…
The annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost sharing practices, conducted by the Kaiser Commission on Medicaid and the Uninsured with the Georgetown University Center for Children and Families, found that, in 2010, coverage in Medicaid and the Children's Health Insurance Program remained strong with some improvements, particularly for low-income children. However, eligibility for their parents and other low-income adults continued to lag behind. The survey also…
Despite tight budgets, nearly all states maintained or made targeted expansions or improvements in their Medicaid and Children’s Health Insurance Programs (CHIP) eligibility and enrollment rules in 2010, preserving the programs’ important role of providing coverage to millions of low-income Americans who otherwise lack affordable options. This stability in large part reflects the temporary fiscal relief for Medicaid provided by the American Recovery and Reinvestment Act of 2009 (ARRA) that was tied to requirements for…
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