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  • The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and Questions

    Fact Sheet

    The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and Questions This fact sheet summarizes Vermont’s Section 1115 waiver to make fundamental changes to its Medicaid program that provides long-term services and supports to eligible, low-income state residents. The waiver was designed to increase access to home and community-based services (HCBS), reduce use of institutional services and control overall costs for long-term services spending. The state hopes to achieve these goals by limiting…

  • New Developments in Medicaid Coverage: Who Bears Financial Risk and Responsibility?

    Issue Brief

    A few recent state Medicaid initiatives have emerged that take the program into new directions. States have expressed a number of objectives in developing these approaches, including offering beneficiaries greater choice, promoting personal responsibility and healthier behaviors among enrollees, and, in some cases, relying more heavily on the private marketplace. In addition, states have sought to shape their initiatives in ways that could help them better predict and limit their exposure to costs. This brief…

  • Vermont’s Global Commitment Waiver: Implications for the Medicaid Program

    Issue Brief

    This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program. In the fall of 2005, Vermont secured approval for a Section 1115 Medicaid waiver known as the "Global Commitment waiver" that allows the state to fundamentally restructure its Medicaid program. The…

  • Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah

    Report

    With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation's 2004 survey of the experiences of Medicaid beneficiaries under Utah's 2002 waiver provide insights into the implications of limited benefits for the low-income population. The results are featured in the March/April edition of…

  • Premium Assistance Programs:  How Are They Financed and Do States Save Money?

    Issue Brief

    Premium Assistance Programs: How Are They Financed and Do States Save Money? This brief examines premium assistance programs implemented under section 1115 waivers in five states (Illinois, New Jersey, Oregon, Rhode Island, Utah) to determine how they are financed; their eligibility, benefit, and cost sharing requirements; their methods for determining cost-effectiveness; and cost savings. Issue Brief (.pdf) Executive Summary (.pdf)

  • Coverage Gains Under Recent Section 1115 Waivers: A Data Update

    Issue Brief

    This brief assesses the extent to which recent Section 1115 waivers have helped reduce the number of uninsured people and finds that there has been a net gain in coverage of 426,329 people under recent waivers. Issue Paper (.pdf)

  • Medicaid 1915(c) Home and Community-Based Service Programs: Data Update

    Issue Brief

    Over the last four years, the Commission has been tracking the national development of the three main Medicaid HCBS programs that states can operate. The Commission also began to survey the policies, such as eligibility criteria and waiting lists that states can use to control the growth of spending on the waiver programs. This brief presents the latest data on the development of home and community-based service programs in Medicaid. Issue Paper (.pdf)

  • Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences

    Issue Brief

    Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public coverage programs. This brief reviews the key findings from this recent activity, including the impact on enrollment in public coverage programs, access to care, and providers. Issue Paper (.pdf)