This issue brief summarizes the DC federal district court’s June 29, 2018 decision in Stewart v. Azar, the lawsuit brought by Medicaid enrollees challenging the HHS Secretary’s approval of the Kentucky HEALTH Section 1115 waiver program, which includes a work requirement, premiums, coverage lockouts, and other provisions that the state estimated would lead 95,000 people to lose coverage.
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New Analysis Illustrates Potential Impact of Medicaid Work Requirements on Coverage if Implemented Nationally as Called for by House Budget Committee and Senate Legislation
As a number of states pursue Medicaid waivers to require certain beneficiaries to work in order to receive benefits, the House Budget Committee passed a budget resolution this month calling for the enactment of Medicaid work requirements in all states, a goal also advanced in proposed legislation in the Senate…
A number of states have received approval for, have applied for, or are considering Medicaid waiver proposals that would impose work requirements as a condition of eligibility, and some policymakers are calling for a federal requirement that all states implement work requirements in Medicaid. This analysis provides illustrative scenarios of potential nationwide reductions in Medicaid coverage if all states implemented work requirements similar to those currently proposed. The scenarios assume low and high disenrollment rates tied to compliance with the work requirements and related problems with reporting, based on disenrollment rates reported in existing studies of the effect of Medicaid reporting requirements and state estimates of enrollment under proposed waivers.
Despite historic coverage gains under the Affordable Care Act (ACA), more than 27 million people in the United States remain without insurance coverage. Recent debate over the future of the ACA has led to uncertainty and confusion about whether and how ACA coverage will be maintained, but millions of currently uninsured people are eligible for ACA coverage under current law. This analysis provides national and state-by-state estimates of eligibility for ACA coverage options among those who remained uninsured.
With the opioid epidemic continuing, state interest in expanding access to substance use disorder (SUD) services remains high. Medicaid financed 21% of SUD services and 25% of mental health services in 2014. Section 1115 waivers related to behavioral health remain the most frequent type of waiver sought and obtained by states, with most requesting authority to use federal Medicaid funds for services provided in “institutions for mental disease” (IMDs). Since Medicaid’s inception, Congress has prohibited states from using Medicaid funds for IMD services for non-elderly adults. This brief provides new data and answers key questions about the Medicaid IMD payment exclusion as waiver activity continues, and Congress considers legislative changes, including a House bill that would restrict IMD SUD services to those with opioid use disorder, excluding those with other SUDs.
KFF/EHF Poll: Texans’ Top State Health Priorities Include Lowering Out-of-Pocket Costs and Reducing Maternal Mortality
Most Texans Don’t Know their State has the Nation’s Highest Uninsured Rate Texans’ top health care priorities for the state revolve around making health care and prescription drugs more affordable, reducing maternal mortality and increasing access to health insurance coverage, finds a new statewide Kaiser Family Foundation/Episcopal Health Foundation survey…
As part of the new Kaiser Family Foundation/Episcopal Health Foundation 2018 Texas Health Policy Survey, this brief explores Texans’ views on health policy priorities at both the state and national level. It examines how Texas residents view state spending on health care and how they rank initiatives such as lowering health care costs, reducing maternal mortality, and funding for mental health care. It also explores Texans’ views on the Affordable Care Act and Medicaid, including personal connections to the Medicaid program and support for Medicaid expansion.
Only Six Percent of Adult Medicaid Enrollees Targeted by States’ New Work Requirements Are Not Already Working and Are Unlikely to Qualify for an Exemption
Among enrollees targeted in the push for work requirements for “able-bodied adults” in Medicaid, only 6 percent are not already working and unlikely to qualify for an exemption, according to an analysis from the Kaiser Family Foundation. Nationally, more than 6 in 10 nonelderly adults in Medicaid who do not…
As of June 2018, four states have approved waivers to implement Medicaid work requirements, seven states have waiver requests pending with CMS, and other states are considering or developing work requirement programs. This brief builds on previous analyses and provides additional detail to examine work and Medicaid, including the work status and types of jobs held by Medicaid adults, the relationship between work and financial stability among Medicaid adults, and potential challenges in fulfilling work, reporting, or exemption process requirements. Data suggest that the population not working and not eligible for an exemption from the work requirements could be narrow, but new requirements would have implications for a broader scope of Medicaid enrollees due to the nature of their jobs and potential barriers to complying with reporting requirements.
In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, 2.4 million poor uninsured adults are in this situation. This brief presents estimates of the number of people in non-expansion states who could have been reached by Medicaid but instead fall into the coverage gap, describes who they are, and discusses the implications of them being left out of ACA coverage expansions.