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Views of Governors and Insurance Commissioners on ACA Repeal and Changes to Medicaid: Responses to a Congressional Request for State Input on Health Reform

This brief summarizes responses from governors and insurance commissioners in 35 states, including DC, to a request from members in the House of Representatives for state input on health care reforms. These responses provide insight into state leaders’ views on repeal and replacement of the ACA and the changes Congress is considering making to the financing and structure of Medicaid. It finds that respondents have mixed views on the ACA and potential repeal and replacement of the ACA; most respondents expressed cautions or concerns about repeal, which are shared among both Republicans and Democrats and those who oppose and support appeal; more respondents expressed concerns about capped Medicaid financing than indicated support, and those that expressed support included significant caveats; less than half of respondents, mostly Republican, cited interest in increased state Medicaid flexibility; over half of respondents supported returning authority to states to regulate insurance markets; and few respondents expressed interest in allowing the sale of insurance across state lines, HSAs, or high risk pools.

Data Note: Variation in Per Enrollee Medicaid Spending Across States

Proposals to transition Medicaid a block grant or per capita cap would reduce federal spending. To understand per capita cap proposals, it is helpful to understand variation in per enrollee spending and per enrollee spending growth across states and enrollment groups. A per capita cap policy could lock in historic variation. This data note uses interactive maps and tables to show variation in per enrollee spending and spending growth by state and eligibility group.

Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA

This brief reviews medical underwriting practices by private insurers in the individual health insurance market prior to 2014, and estimates how many American adults could face difficulty obtaining private individual market insurance because of a pre-existing condition if the Affordable Care Act (also known as Obamacare) were repealed or amended and such practices resumed.

Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017

This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings in this report are drawn from the 16th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2016 and those implemented or planned for FY 2017 based on information provided by the nation’s state Medicaid directors. Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, and covered benefits (including prescription drug policies).

The Gap in Medigap

This policy insight examines the low rate of Medigap coverage among people under age 65 with disabilities on Medicare and the federal law that governs consumer rights and protections related to Medigap open enrollment.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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