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Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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Explore the latest national and state-specific data and policies on women’s health, including health status, insurance coverage, use of preventive services, and more.

Most "dual-eligible" individuals (8.9 million in 2024) are eligible for Medicaid benefits that are not otherwise covered by Medicare, including long-term care.

Use this tool to build a custom report compiling health-related data for a single state or multiple states.

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  • Fewer Want To Expand Medicaid After Hearing Their State Could Spend More

    Feature

    Fewer Want To Expand Medicaid After Hearing Their State Could Spend More Download Source Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health, The Public’s Health Care Agenda for the 113th Congress (conducted January 3-9, 2013)

  • Ensuring the Health Care Needs of Women: A Checklist for Health Exchanges

    Issue Brief

    To inform the development of the state health insurance Exchanges under the Affordable Care Act, this checklist identifies key coverage, affordability and access issues that are important for women. Based on lessons learned from women’s health research and the Massachusetts experience, the checklist considers essential health benefits, implementation of no-cost preventive services including contraception, provider networks and affordability, outreach and enrollment efforts, and the importance of including gender and other demographic characteristics in data collection…

  • Quick Take: Medicaid: 3 Key Issues to Watch in 2013

    Fact Sheet

    2013 will be a historic year for Medicaid with the implementation of major provisions to expand coverage and streamline enrollment in the Affordable Care Act (ACA) less than a year away, a surge in activity around care delivery reforms that seek to improve care and potentially reduce costs, and the unfolding of fiscal developments at the state and federal level. Today, Medicaid provides health and long-term care coverage to more than 60 million low-income children,…

  • The Single Streamlined Application Under the Affordable Care Act: Key Elements of the Proposed Application and Current Medicaid and CHIP Applications

    Report

    The Affordable Care Act (ACA) makes a number of changes to simplify the Medicaid enrollment process. As part of these changes, beginning in 2014 all states will be required to use a single, streamlined application provided by the U.S. Secretary of Health and Human Services unless they receive approval to use an alternative application. A draft version of the streamlined application was released for public comment on January 28, 2013. This analysis provides an overview…

  • How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees

    Issue Brief

    This brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will be wide state variation. The paper presents data showing how states compare in their 2012 Medicaid fee levels, how Medicaid fees compared to Medicare fees,…

  • Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

    Issue Brief

    To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to attract new physicians to Medicaid and provide greater support for physicians who already participate. As a result, Medicaid fees paid to certain physicians for primary…

  • Health Insurance Market Reforms: Rate Review

    Fact Sheet

    Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the Affordable Care Act (ACA), federal regulators may review rate increases in some cases. This fact sheet explains how rate review works and how the ACA…

  • Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

    Fact Sheet

    Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group markets lack access to key benefits; the Department of Health and Human Services (HHS) estimates that 62% of health plan enrollees in the individual market…

  • State Fiscal Conditions and Medicaid Program Changes, FY 2012-2013

    Fact Sheet

    The Medicaid program provides health and long-term care coverage for low-income families who lack access to other affordable coverage options and for individuals with disabilities for whom private coverage is often not available or inadequate. Medicaid also plays a pivotal role in state budgets, both as an expenditure and a source of federal revenues. This fact sheet provides a brief overview of Medicaid’s role in state budgets, the impact of the recession, current fiscal conditions,…