An explainer on how Medicaid is financed, whom it covers and how spending is distributed across groups, as policymakers consider restructuring the program.
In the debate about Medicaid’s future, some critics have made statements at odds with data, research, and basic information about Medicaid. Let’s get the facts straight.
There are 11.2 million children in the U.S. with special health care needs such as Down syndrome, cerebral palsy and autism.
Medicaid Restructuring: Key Resources Related to the Debate Over Medicaid Financing
- Restructuring Medicaid in the American Health Care Act: Five Key Considerations
- Data Note: What if Per Enrollee Medicaid Spending Growth Had Been Limited to CPI-M from 2001-2011?
- Implications of Reduced Federal Medicaid Funds: How Could States Fill the Funding Gap?
- 5 Key Questions: Medicaid Block Grants & Per Capita Caps
We document how Medicaid spending per enrollee for seniors and people with disabilities varies greatly by state and discuss potential implications of a Medicaid per capita cap.
Chronic illness is prevalent in the adult Medicaid population. This data note focuses on Medicaid’s role in providing access to preventive care for low-income adults.
- Work requirements
- Time limits
- Premiums with lock-out for nonpayment
Our fact sheets highlight the role and reach of Medicaid in every state.
- Most doctors (70%) accept new Medicaid patients
- Access to care in Medicaid is comparable to private insurance
- Evidence about Medicaid’s impact on health outcomes continues to emerge
Medicaid coverage and financing facilitate access to a variety of behavioral health services.
A look at Medicaid’s role for 52 million nonelderly children and adults living in the most rural areas in the United States.
Our summary reviews findings from 108 studies of the impact of state Medicaid expansions under the ACA published between January 2014 and January 2017.
A 1-page distillation of information and statistics about the opioid epidemic and Medicaid’s role in covering addiction treatment services.
Medicaid Restructuring and Special Populations
We look at waivers that implement the ACA’s Medicaid expansion and highlight themes in approved, pending, and denied provisions to date as well as key issues to watch.
Section 1115 waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. They generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS).
A look at the current landscape of demonstration waivers and what to watch going forward.
Total newly eligible Medicaid expansion
enrollees: 10.7 million