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Nearly 20 Million Children Live in Immigrant Families that Could Be Affected by Evolving Immigration Policies

President Trump has intensified national debate about immigration by implementing policies to enhance immigration enforcement and restrict legal immigration. Recent findings show that the climate surrounding these policies has significantly increased fear and uncertainty among immigrant families, broadly affecting families across different immigration statuses and locations. The effects extend to lawfully present immigrants, including lawful permanent residents or “green card” holders, and children in immigrant families, who are predominantly U.S.-born citizens. In particular, findings point to both short- and long-term negative consequences on the health and well-being of children in immigrant families.
Potential changes to public charge policies intended to reduce use of public programs by immigrant families, including their citizen children, could further increase strains on immigrant families and lead to losses in health coverage. To provide insight into the scope of potential impacts of continually evolving immigration policy on children, this data note provides nationwide and state-level estimates (Table 1) of citizen children living in immigrant families and the number currently covered by Medicaid/CHIP coverage.

Key Questions about Medicaid Payment for Services in “Institutions for Mental Disease”

With the opioid epidemic continuing, state interest in expanding access to substance use disorder (SUD) treatment services remains high. Medicaid plays a key role in financing behavioral health care, paying for 21% of SUD services and 25% of mental health services as of 2014. Additionally, Medicaid Section 1115 waivers related to behavioral health currently are the most frequently sought type of waiver by states. In recent years, most states seeking behavioral health waivers request authority to use federal Medicaid funds for services provided in “institutions for mental disease” (IMDs, an antiquated term in the statute). Since the creation of the Medicaid program, Congress has prohibited states from using Medicaid funds to pay for IMD services for non-elderly adults (ages 19-64). This brief answers key questions about the nature and history of the Medicaid IMD payment exclusion and identifies current administrative and legislative issues to watch.

Nonelderly Adults with Opioid Addiction Covered by Medicaid Were Twice as Likely as those with Private Insurance or the Uninsured to Have Received Treatment in 2016

Among the 1.9 million nonelderly adults with opioid addiction, those with Medicaid were twice as likely as those with private insurance or no insurance to have received treatment in 2016, according to a new analysis by the Kaiser Family Foundation. The role of Medicaid in combating the opioid epidemic has…

The Opioid Epidemic and Medicaid’s Role in Facilitating Access to Treatment

This issue brief provides an overview of Medicaid’s role in addressing the opioid epidemic. It includes information on the characteristics of nonelderly adults with opioid addiction and utilization of different types of treatment services among people with different insurance statuses, and provides an overview of treatment services that are covered by Medicaid. It also discusses the potential implications of the Section 1115 work and premium requirements on states’ ability to address the epidemic.

Governors’ Proposed Budgets for FY 2019: Focus on Medicaid and Other Health Priorities

This issue brief provides Medicaid highlights from governors’ proposed budgets for state fiscal year (FY) 2019 (July 1, 2018 through June 30, 2019 in most states). Proposed budgets reflect the priorities of the governor and are often blueprints for the legislature to consider. In total, we reviewed 39 proposed state budgets and text from 46 state of the state speeches. This review revealed that while state revenue collections improved in 2017 compared to 2016, considerable economic and regional variation persists, many states are facing significant budget challenges unrelated to Medicaid such as unfunded pension liabilities or falling oil prices, and the outlook for 2018 remains uncertain due, in part, to the impacts of the 2017 Federal Tax Reform Act.

Medicaid Waiver Tracker: Which States Have Approved and Pending Section 1115 Medicaid Waivers?

This resource tracks states with approved Section 1115 Medicaid waivers and pending waivers (which include new waiver applications, waiver amendments, and renewals). View approved and pending waivers according to waiver category. Related waiver resources are available by topic at the bottom of the page, as are additional details on each approved and pending waiver.

Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016

This report provides information on recent trends in nursing facilities in the United States, drawing on data from the federal On-line Survey, Certification, and Reporting system (OSCAR) and more recent Certification and Survey Provider Enhanced Reports (CASPER). We use these databases to provide information on nursing facility characteristics, resident characteristics, facility staffing, and deficiencies by state from 2009 through 2015. This data enables policymakers and the public to monitor and understand recent changes in nursing facility care in the United States and help highlight areas of ongoing concern for current and future policy making.

How Might Older Nonelderly Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waivers?

Most of the states with approved or pending Section 1115 waivers that condition Medicaid eligibility on work would apply those requirements to all or most nonelderly adults (ages 19-64) who are not receiving Supplemental Security Income (SSI) cash assistance, including older nonelderly adults (ages 50-64). Older nonelderly adults may be limited in their ability to satisfy a work requirement due to barriers resulting from age and/or disability. Previous analysis shows that many nonelderly Medicaid adults (ages 19-64) have functional limitations that may interfere with their ability to work but do not rise to the stringent SSI level of disability, making them potentially subject to work requirements. Older nonelderly adults are over twice as likely to have a disability than younger adults (17% vs. 7%). Furthermore, older nonelderly adults account for nearly half (45%) of all nonelderly Medicaid adults with a disability but not SSI who could be affected by a work requirement. This analysis examines the implications of work requirements for Medicaid adults ages 50 to 64 (referred to as “older nonelderly Medicaid adults”) and provides national and state level estimates of their disability, SSI, and work status using data from the 2016 American Community Survey (ACS).

Where Are States Today? Medicaid and CHIP Eligibility Levels for Children, Pregnant Women, and Adults

This fact sheet provides an overview of eligibility levels for children, pregnant women, parents, and other non-disabled adults in Medicaid and CHIP. The data are based on eligibility levels reported by states as of January 2018. The findings highlight Medicaid’s continued role as a primary source of coverage for children and pregnant women and its expanded role for low-income adults under the Affordable Care Act (ACA).

The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review

This issue brief summarizes findings from 202 studies of the impact of state Medicaid expansions under the ACA published between January 2014 (when the coverage provisions of the ACA went into effect) and February 2018. It includes studies, analyses, and reports published by government, research, and policy organizations using data from 2014 or later. This body of research suggests that the expansion presents an opportunity for gains in coverage, improvements in access and financial security, and economic benefits for states and providers.

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