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In an Axios column, Drew Altman discusses how, ironically, efforts by red states to move their ACA marketplaces and their Medicaid programs in more conservative directions could end up strengthening the ACA and Medicaid politically over the longer term.
On January 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a State Medicaid Director letter announcing a new policy that, for the 1st time, allows states to condition Medicaid on participation in a work or “community engagement” program. The next day, CMS approved a new Medicaid waiver in Kentucky. The waiver includes a program called Kentucky HEALTH, which encompasses a work requirement as well as coverage lockouts of up to 6 months for failure to pay monthly premiums (up to 4% of income), timely renew eligibility, or timely report a change in circumstances, among other provisions. Kentucky HEALTH applies to most nonelderly adults, including low-income parents and expansion adults. The state plans to implement Kentucky HEALTH by July, 2018. On January 24, 2018, 15 Kentucky Medicaid enrollees filed a lawsuit in the U.S. District Court for the District of Columbia challenging CMS’s authority to issue the work requirement policy and approve the Kentucky waiver. This issue brief answers 5 key questions about the case.
While efforts to pass major federal legislation to repeal and replace the Affordable Care Act (ACA) and restructure and reduce federal Medicaid financing may be on hold temporarily, the focus of the Centers for Medicare and Medicaid Services (CMS) and states is expected to turn to achieving significant Medicaid program changes through Section 1115 demonstration waivers. This issue brief presents three questions to help analyze the evolution of federal waiver policy as new waiver proposals and decisions emerge.
State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people with behavioral health needs, and financing delivery system reforms.
In this column for the JAMA Health Forum, Larry Levitt explores what President-elect Biden might do to advance his health care vision both through legislation and through executive orders and waivers and demonstrations.
The recent election of former Vice President Joe Biden as well as the on-going effects of the coronavirus pandemic and related economic downturn are the key issues that will substantially shape Medicaid policy over the next year.
This fact sheet provides an overview of changes to BadgerCare, Wisconsin's 1115 waiver demonstration project, and how it relates to the Affordable Care Act's Medicaid expansion.
This brief will examine similarities and difference across key elements of DSRIP waivers. The states included in this analysis are: California, Texas, Kansas, New Jersey, Massachusetts, and New York. The key elements of DSRIP initiatives that will be explored in this analysis include: the goals and objectives of the DSRIP initiative; eligible providers; projects and organization; allocation of funds; data collection and evaluation/reporting; and financing of DSRIP waivers.
This issue brief compares the financial alignment demonstrations for beneficiaries who are dually eligible for Medicare and Medicaid in states that have memoranda of understanding approved by the Centers for Medicare and Medicaid Services.
This slide shows the current status of state decisions to use Section 1115 waivers to expand Medicaid. A total of 31 states including DC have adopted the ACA Medicaid expansion, including 6 states with ACA 1115 ACA expansion waivers. AZ has a pending waiver application that seeks changes to its expansion. MT and NH’s waivers will take effect on 1/1/16. PA originally expanded through a waiver but subsequently transitioned to a state plan amendment. TN and UT have debated waiver proposals which have not been approved by their state legislatures or submitted to CMS.
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