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From Ballot Initiative to Waivers: What is the Status of Medicaid Expansion in Utah?

The Utah legislature significantly changed and limited the Medicaid coverage expansion that was adopted by the voters through a ballot initiative in November 2018. This issue brief explains new provisions in Utah’s recently amended Section 1115 Medicaid waiver and the additional amendments that the state has submitted to CMS, including most recently a request for enhanced ACA federal matching funds for an expansion to 138% FPL with an enrollment cap.

Opioid Use Disorder among Medicaid Enrollees: Snapshot of the Epidemic and State Responses

As the largest payer of substance use disorder services in the United States, Medicaid plays a central role in state efforts to address the opioid epidemic. In addition to increasing access to addiction treatment services through the expansion of Medicaid under the Affordable Care Act (ACA), states are expanding Medicaid addiction treatment services, increasing provider reimbursements, restricting opioid prescribing, and implementing delivery system reforms to improve the quality of treatment services. While many states have been tracking progress and challenges in these efforts, uniqueness of state systems can make it difficult to compare or benchmark across states. This brief draws on analyses provided by the Medicaid Outcomes Distributed Research Network (MODRN), a collaborative effort to analyze data across multiple states to facilitate learning among Medicaid agencies. It profiles the opioid epidemic among the Medicaid population in six states participating in MODRN that also have been hard hit by the opioid epidemic: Kentucky, Maryland, Ohio, Pennsylvania, Virginia, and West Virginia. The brief also draws on interviews with officials from the state Medicaid and other health agencies.

Understanding the Medicaid Prescription Drug Rebate Program

Drug prices are at the center of health policy debates at both the state and federal levels. . Policymakers are currently debating significant changes to payment for prescription drugs through Medicare and commercial insurers that may also have implications for Medicaid and the Medicaid Prescription Drug Rebate Program (MDRP). This brief explains the MDRP to help policymakers and others understand how Medicaid pays for drugs and any potential consequences of policy changes for the program.

State Options for Medicaid Coverage of Inpatient Behavioral Health Services

This report provides data to understand current patterns of Medicaid enrollees’ use of inpatient and outpatient substance use disorder and mental health treatment services; explains the options for states to access federal Medicaid funds for enrollees receiving IMD services; analyzes current Section 1115 waiver activity; and draws on interviews with policymakers using IMD waivers in Vermont, Virginia, and San Diego County to examine successes and challenges

Addressing Health and Social Needs of California’s Immigrant Families: Lessons Learned from Local Responses and Future Priorities

A flurry of federal activity on immigration rules and policies is affecting health care and coverage for both lawfully residing immigrants and undocumented immigrants in the country, ranging from deportation policies, a revised “public charge” rule, and a new proclamation from President Trump requiring health insurance for entry via immigrant…

State Budgets for Fiscal Year 2020 Include Total Medicaid Spending Growth of 6.2 Percent on Average, Even As Enrollment Remains Essentially Flat  

States budgeted for total Medicaid spending to increase at a faster pace than enrollment in fiscal year 2020, driven in part by rising costs for prescription drugs, provider rate increases and higher costs associated with caring for the elderly and disabled, according to KFF’s new 50-state Medicaid budget survey. The…

Medicaid Spending, Enrollment and Policy Trends: A View from the States

On Friday, Oct. 18, KFF released its 19th annual 50-state Medicaid budget survey for state fiscal years 2019 and 2020. KFF and the National Association of Medicaid Directors (NAMD) held a joint briefing to discuss trends in enrollment and spending and highlight key Medicaid policy developments.

Mapping Medicaid Delivery System and Payment Reform

This interactive provides state-by-state data on Medicaid delivery system and payment reform initiatives. Users can track state Medicaid managed care, patient-centered medical home (PCMH), Health Home, Accountable Care Organization (ACO), and Delivery System Reform Incentive Payment (DSRIP) waiver activity.