Medicaid/CHIP - Health Policy, Public Opinion & Research

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The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession
The annual 50-state survey by the Foundation's Kaiser Commission on Medicaid and the Uninsured finds sharp rises in Medicaid enrollment and spending during the economic downturn, straining state budgets and pressuring officials to curb program costs despite extra financial help from the federal government.

A Foundation for Health Reform: Findings of An Annual 50-State Survey of Eligibility Rules, Enrollment and Renewal Procedures and Cost-Sharing Practices in Medicaid and CHIP for Children and Parents During 2009
This package of resources presents findings of an annual 50-state survey of Medicaid and CHIP eligibility and enrollment policies, as well as other papers on states' efforts to cover children and low-income adults.

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Medicaid and Managed Care: Key Data, Trends, and Issues -- February 2010

This policy brief provides an overview of the Medicaid program’s increasing reliance on managed care to deliver services. The goal of this approach is to improve access to care and coordination of care by assuring that enrollees have a "medical home" with a primary care provider, and to rely more heavily on preventive and primary care.

Building an Express Lane Eligibility Initiative: A Roadmap of Key Decisions for States -- January 2010
The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes new Express Lane Eligibility provisions that provide states new options to reach and enroll eligible but uninsured low-income children into Medicaid and CHIP by relying on eligibility findings from other need-based programs, such as Head Start or the National School Lunch Program. This brief, the third in a series called Putting Children on the Express Lane to Health Insurance, brief provides an overview of key decisions a state will need to address in designing an ELE initiative.

Medicaid and Children’s Health Insurance Program Provisions in Health Reform Bills: Affordable Health Care for America Act & The Patient Protection and Affordable Care Act – January 2010 -- January 2010
This brief compares the Medicaid and Children's Health Insurance Program provisions in the House health reform legislation, the Affordable Health Care for America Act, as passed by the full House on Nov. 7, 2009, with the Senate’s reform legislation, the Patient Protection and Affordable Care Act, as passed on Dec. 24, 2009.

Access to Abortion Coverage and Health Reform -- January 2010
This issue brief discusses the treatment of coverage for abortion services under the major health reform bills and explores the possible impact of the leading House and Senate passed legislation on coverage for abortion services.

Summaries of Coverage Provisions In House and Senate Reform Legislation -- January 2010
These two-page summaries describe the health coverage provisions contained in the House reform legislation as approved on Nov. 7, 2009 and the Senate reform legislation as approved on Dec. 24, 2009.

Racial/Ethnic Disparities in Access to Care Among Children: How Does Medicaid do in Closing the Gaps? -- December 2009
This report assesses how disparities in access to care in Medicaid and the Children’s Health Insurance Program compare with disparities among privately insured and uninsured children.

Alternatives for Financing Medicaid Expansions in Health Reform -- December 2009

This report examines alternative ways of financing Medicaid expansions than those included in leading health reform legislation in the House and Senate. The analysis shows that it is possible to distribute increased federal payments in multiple alternative ways that could be less complicated and would avoid the inequities associated with providing higher matching rates just for new eligible Medicaid enrollees.

Briefing - A Foundation for Health Reform: Findings of An Annual 50-State Survey of Eligibility Rules, Enrollment and Renewal Procedures and Cost-Sharing Practices in Medicaid and CHIP for Children and Parents During 2009 -- December 2009
This package of resources presents findings of an annual 50-state survey of Medicaid and CHIP eligibility and enrollment policies, as well as other papers on states' efforts to cover children and low-income adults.

Coverage of Low-Income Children: Key Issues to Consider in Health Reform -- December 2009
This issue brief examines several key issues to consider about low-income children's coverage under health reform. It will be important to consider how to build upon Medicaid and CHIP, develop effective relationships and transitions between public and private coverage, and assure that low-income children receive coverage that meets the full range of their health needs. Adequately planning and funding for the transition to reform will be key to preventing any disruptions in children's coverage or care.

Where Are States Today? Medicaid and State-Funded Coverage Eligibility Levels for Low-Income Adults -- December 2009

This fact sheet provides a brief overview of low-income adults' current eligibility for Medicaid and other state-funded coverage programs and a discussion of how this coverage may be impacted by health reform.

The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes new Express Lane Eligibility provisions that provide states new options to reach and enroll eligible but uninsured low-income children into Medicaid and CHIP by relying on eligibility findings from other need-based programs, such as Head Start or the National School Lunch Program. This brief, the third in a series called Putting Children on the Express Lane to Health Insurance, brief provides an overview of key decisions a state will need to address in designing an ELE initiative.

This brief compares the Medicaid and Children's Health Insurance Program provisions in the House health reform legislation, the Affordable Health Care for America Act, as passed by the full House on Nov. 7, 2009, with the Senate’s reform legislation, the Patient Protection and Affordable Care Act, as passed on Dec. 24, 2009.

This issue brief discusses the treatment of coverage for abortion services under the major health reform bills and explores the possible impact of the leading House and Senate passed legislation on coverage for abortion services.

These two-page summaries describe the health coverage provisions contained in the House reform legislation as approved on Nov. 7, 2009 and the Senate reform legislation as approved on Dec. 24, 2009.

This report assesses how disparities in access to care in Medicaid and the Children’s Health Insurance Program compare with disparities among privately insured and uninsured children.

This package of resources presents findings of an annual 50-state survey of Medicaid and CHIP eligibility and enrollment policies, as well as other papers on states' efforts to cover children and low-income adults.

This issue brief examines several key issues to consider about low-income children's coverage under health reform. It will be important to consider how to build upon Medicaid and CHIP, develop effective relationships and transitions between public and private coverage, and assure that low-income children receive coverage that meets the full range of their health needs. Adequately planning and funding for the transition to reform will be key to preventing any disruptions in children's coverage or care.

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Medicaid/CHIP

Medicaid is the nation's public health insurance program for low-income Americans, financing health and long term care services for more than 55 million individuals. The program provides access to affordable and comprehensive health care for children and adults in low-income working families and for the elderly and disabled who often rely on the program to fill in critical gaps in their Medicare coverage. Although three quarters of Medicaid's enrollees are adults or children, the elderly and disabled account for 70% of the program's expenditures. Financed and operated jointly by the states and federal government, Medicaid accounts for roughly one sixth of the nation’s health care spending and almost half of all spending on long term care. As the largest source of federal support to the states, Medicaid is also a major engine in state economies, supporting millions of jobs across the country. Its guarantee of open-ended federal financing that matches state spending enables states to respond to losses of private health insurance attributable to unemployment and rising health insurance premiums, increases in health care costs, emergencies and disasters, and an aging society.

The State Children's Health Insurance Program (CHIP) was enacted in 1997 to provide a capped amount of federal matching funds to states for coverage of children and some parents with incomes too high to qualify for Medicaid, but for whom private health insurance was either unavailable or unaffordable. Covering roughly four million children, CHIP has played an important role in reducing the number of uninsured children in America.

This section provides data and information on the Medicaid and CHIP programs with a focus on the populations they serve. Analyses of proposals to restructure these programs, data from surveys, studies of the impact of recent programmatic changes on beneficiaries, and basic information on how the programs operate and are administered can all be found here. These materials can help to inform discussions of reform proposals and efforts to improve and maintain health coverage and financing for the low-income disabled and elderly populations, families, and children who are left out of our country’s fragmented, employer-based health care system.

The Kaiser Commission on Medicaid and the Uninsured is the main source for the Foundation's work related to the Medicaid and CHIP programs. Begun in 1991, the Commission is the largest operating program of Henry J. Kaiser Family Foundation and has brought increased analysis and attention to health coverage issues facing the low-income population for over a decade. Through its reports and briefings, the Commission continues to provide up-to-date information on Medicaid and CHIP and assesses options for reform.