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  • Using Medicaid to Wrap Around Private Insurance: Key Questions to Consider

    Issue Brief

    This issue brief raises three key questions for consideration if using Medicaid to wrap around private coverage is going to be considered as an alternative to the ACA's Medicaid expansion under the BCRA. We draw on existing information about state Medicaid premium assistance programs to date, the administrative complexity involved, and the financing implications of premium assistance programs.

  • Supporting Work without the Requirement: State and Managed Care Initiatives

    Issue Brief

    The Centers for Medicare and Medicaid Services (CMS) continues to promote state adoption of work and reporting requirements as a condition of Medicaid eligibility for certain nonelderly adults, although several such waivers have been set aside by federal courts. While most Medicaid adults are already working, some states and health plans have developed voluntary work support programs for nonelderly adults who qualify for Medicaid through non-disability pathways. These programs offer services that support work without conditioning Medicaid eligibility on having a job. This brief examines opportunities for and limitations on federal and state support of such programs, highlights several state and health plan initiatives, and explores their common themes.

  • Key State Policy Choices About Medical Frailty Determinations for Medicaid Expansion Adults

    Issue Brief

    This issue brief answers 3 key questions and provides new data about state medical frailty determinations, which are assuming greater importance as more states adopt restrictive Section 1115 waivers that exempt medically frail enrollees from policies such as work requirements and premiums. The findings are excerpted from our 50-state survey on Medicaid financial eligibility for seniors and people with disabilities.

  • Medicaid: What to Watch in 2021

    Issue Brief

    As the Biden Administration takes office, the ongoing effects of the coronavirus pandemic and related economic downturn are the key issues that will substantially shape Medicaid coverage and financing policy in the year ahead.

  • Section 1332 State Innovation Waivers: Current Status and Potential Changes

    Issue Brief

    Section 1332 of the Affordable Care Act (ACA) authorizes states to waive key requirements under the law in order to experiment with different health coverage models. As Republicans in Congress debate repeal and replacement of the ACA, renewed attention is being paid to these waivers as a mechanism for giving states flexibility to restructure their health care markets. This brief describes current 1332 waiver activity, including proposals in the Senate's Better Care Reconciliation Act (BCRA), and raises questions regarding the future of these waivers, particularly in the context of proposed changes under discussion.

  • 3 Key Questions About the Arkansas Medicaid Work and Reporting Requirements Case

    Issue Brief

    This issue brief answers three key questions about the implications of the appeals court’s decision setting aside the Health and Human Services (HHS) Secretary’s approval of a Section 1115 Medicaid waiver amendment that included work and reporting requirements and restriction of retroactive coverage in Arkansas.

  • Medicaid: What to Watch in 2023

    Issue Brief

    As 2023 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.

  • CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio

    Fact Sheet

    This fact sheet discusses CMS's denial of Ohio's proposed changes to its existing Medicaid expansion . It also provides an overview of the proposed changes as included in the state's Section 1115 demonstration waiver application.