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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.

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.

Data Note: Data Do Not Support Relationship Between Medicaid Expansion Status and Home and Community-Based Services Waiver Waiting Lists

Some have said that state choices about whether to adopt the ACA’s Medicaid expansion come at the expense of providing Medicaid home and community-based services (HCBS). Since 2002, the Kaiser Family Foundation has surveyed states about their HCBS waiver waiting lists. All states offer at least one HCBS waiver for seniors and people with disabilities today. States choose how many people to serve under these waivers, and their ability to limit enrollment can result in waiting lists when the number of people seeking services exceeds the number of waiver slots. This analysis examines the most recent data available, including HCBS waiver waiting list data for 2015 and 2016. The data do not support a relationship between a state’s Medicaid expansion status, which is primarily financed with federal funds, and changes in its HCBS waiver waiting list.

Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2018: Findings from a 50-State Survey

This 16th annual 50-state survey provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2018. It takes stock of how the programs have evolved as the fifth year of implementation of the Affordable Care Act (ACA) begins, discusses policy changes made during 2017, and looks ahead to issues that may affect state policies moving forward. It is based on a survey of state Medicaid and CHIP officials conducted by the Kaiser Family Foundation and the Georgetown University Center for Children and Families. State data are available in Appendix Tables 1-20.

KFF Briefing Examines Progress and Remaining Challenges for the Health Care Systems in Puerto Rico and U.S. Virgin Islands Six Months After Hurricanes Irma and Maria

Six months after hurricanes Irma and Maria made landfall across Puerto Rico and the U.S. Virgin Islands, local officials described progress but also a long road to full recovery of the U.S. territories’ health care systems, economies and infrastructure during a public briefing Monday at the Kaiser Family Foundation’s Washington…

Both Expansion and Non-Expansion States Have Implemented Modernized Medicaid Systems to Streamline Enrollment under the ACA

Under the Affordable Care Act, Medicaid expansion and non-expansion states alike have implemented streamlined Medicaid enrollment systems that facilitate real-time eligibility determinations and automated renewals, according to a new 50-state survey from the Kaiser Family Foundation. Before the ACA, individuals could not apply for Medicaid by phone or online in…

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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.