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Under estate recovery, state Medicaid programs are required to recover the costs of long-term care and related hospital and prescription drug services for enrollees ages 55 and older. KFF examines the wide variation in estate recovery practices across states as well as the criticisms of this policy, which have led to federal proposals to modify or reduce it.
The pandemic continuous enrollment provision and other research show that continuous eligibility reduces Medicaid disenrollment and “churn” rates and helps to ensure stable coverage. As many Medicaid enrollees are currently experiencing disruptions in coverage as a result of the Medicaid unwinding, a number of states are pursuing strategies to help promote continuity of coverage, including through unwinding waivers and Section 1115 demonstration waivers. This Waiver Watch summarizes approved and pending Section 1115 waivers with continuous eligibility provisions for children and adults in Medicaid.
Drawing from KFF’s 50-state survey of state Medicaid HCBS officials, conducted between May and August of 2023, this issue brief describes how states used the PHE authorities to strengthen their HCBS programs, changes as the PHE ends, and the role of family caregivers in providing HCBS.
Family caregivers played a key role in supporting people who used Medicaid home- and community-based services (HCBS) during the COVID pandemic. Many states used new pandemic-era authorities to support and pay family caregivers and maintain services in other ways amid workforce shortages and other challenges.
About 656,000 people across the country were on state waiting lists for home and community-based services financed through Medicaid waivers in 2021, finds a new KFF analysis. But such waiting lists are an incomplete and often inaccurate measure that can both overstate and understate unmet need.
States are currently developing plans to access an increased federal matching rate (“FMAP”) for Medicaid HCBS spending established in the American Rescue Plan Act (ARPA) of 2021. In the future, states may also be able to access increased HCBS funds proposed in the Biden Administration’s American Jobs Plan and the Better Care Better Jobs Act recently introduced in Congress. This brief highlights examples of Medicaid HCBS policy changes authorized through Section 1115 demonstration waivers in seven states (Arizona, Delaware, New Jersey, New York, Rhode Island, Vermont, and Washington). Where available, we discuss waiver evaluation findings and reports that assess the impact of these policy changes.
This issue brief presents FY 2020 state-level data on the number of people receiving Medicaid HCBS and HCBS spending. This is the latest data available, and the first since the onset of the COVID-19 pandemic. The data were collected in KFF’s 19th survey of state officials administering Medicaid HCBS programs in all 50 states and DC. A related brief presents the latest data and highlights themes in key state policy choices about optional HCBS.
This issue brief presents findings on key state policy choices about Medicaid HCBS in FY 2020. This is the latest data available, and the first since the onset of the COVID-19 pandemic. The data were collected in KFF’s 19th survey of state officials administering Medicaid HCBS programs in all 50 states and DC. A related brief presents the latest state-level data about the number of people receiving HCBS and HCBS spending
As California ramps up its CalAIM initiative, the state will incorporate and transition its Whole Person Care pilot program's services statewide through the state’s Medicaid managed care system. This brief examines the lessons from those pilots in coordinating and integrating physical health, behavioral health, and social services.
In a new brief, KFF analysts explain and summarize the recent history of efforts to make work requirements a condition of eligibility for Medicaid in some states.
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