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The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 Election

As the Trump administration reaches the end of its first term, this issue brief considers the landscape of approved and pending Section 1115 Medicaid demonstration waivers under this administration and how the November 2020 presidential election may impact this landscape.

A Reconfigured U.S. Supreme Court: Implications for Health Policy

U.S. Supreme Court decisions shape health policy in important ways. The nomination of Judge Amy Coney Barrett, if confirmed, is expected to establish a solid 6:3 conservative majority that could affect case outcomes in several areas. This issue brief considers the potential implications of a reconfigured Court for health policy issues, including those already on the Court’s docket for the coming term and those that the Court may choose to consider in this term or in the future.

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

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 Work Requirements and People with HIV

This data note examines the potential implications of work requirements for people with HIV, a population that relies heavily on Medicaid and for whom there are important clinical and public health reasons for maintaining consistent access to insurance coverage and HIV care.

Supporting Work without the Requirement: State and Managed Care Initiatives

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.

Understanding the Intersection of Medicaid and Work: What Does the Data Say?

Under the Trump Administration, CMS issued guidance for state Medicaid waiver proposals that would impose work requirements in Medicaid as a condition of eligibility, and several states have received approval for or are pursuing these waivers. This issue brief provides data on the work status of non-dual, non-SSI, nonelderly adults enrolled in Medicaid to understand the potential implications of work requirement proposals in Medicaid. It shows that the majority of adults in this group are already working, and those who are not report major impediments to their ability to work such as illness or caregiving responsibilities.

Disability and Technical Issues Were Key Barriers to Meeting Arkansas’ Medicaid Work and Reporting Requirements in 2018

This issue brief analyzes the impact of the four measures intended to safeguard coverage for people with disabilities and others who should not have been subject to the work and reporting requirements. It draws on data newly available from Arkansas’ 2018 annual waiver report to CMS and monthly data released by the state while the requirements were in effect. The data reveal that few people used these safeguard measures relative to the number of people who lost coverage due to the new requirements. Among those who accessed the safeguards, the vast majority did so due to disability/other health issues or technical issues such as those related to reporting.

Ask KFF: MaryBeth Musumeci Answers 3 Questions on Kentucky, Arkansas Medicaid Work and Reporting Requirement Cases

A federal district court has set aside the HHS Secretary’s approval of Medicaid waivers with work and reporting requirements and other eligibility and enrollment restrictions in Kentucky and Arkansas. For context as this all develops, we asked MaryBeth Musumeci, Associate Director at the Program on Medicaid and the Uninsured, three questions about the implications of the decisions.

February State Data for Medicaid Work Requirements in Arkansas

Arkansas is one of seven states for which CMS has approved a Section 1115 waiver to condition Medicaid eligibility on meeting work and reporting requirements and the first state to implement this type of waiver. The new requirements were phased in for most enrollees ages 30-49 beginning in June 2018, and for individuals ages 19-29 starting in January 2019. Unless exempt, enrollees must engage in 80 hours of work or other qualifying activities each month and must report their work or exemption status by the 5th of the following month using an online portal; as of mid-December 2018, they also may report by phone. Monthly data related to the new requirements released by the Arkansas Department of Human Services show that over 18,000 people were disenrolled from Medicaid for failure to comply with the new requirements in 2018. Those who fail to comply with the requirements for any three months in 2019 can lose coverage beginning in April 2019. This brief looks at data for January 2019. Separate reports look at early implementation of the new requirements and enrollee experiences.

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