As policymakers in Washington discuss Affordable Care Act repeal and a possible block grant for Medicaid, a new issue brief from the Kaiser Family Foundation lays out key questions to consider in restructuring federal financing of the nation’s health insurance program for low-income Americans. Capping federal funding for Medicaid through a…
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This brief explains key components of Michigan and Indiana’s Medicaid expansions under Section 1115 demonstration waivers and presents insights from stakeholder interviews and focus groups about early implementation experience.
The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would have significant implications. To help inform discussion around increased flexibility, this brief provides an overview of current federal standards and state options in Medicaid and how states have responded to these options in four key areas: eligibility, benefits, premiums and cost sharing, and provider payments and delivery systems.
50-State Survey of Medicaid Eligibility and Enrollment Policies in 2017: A Baseline for Measuring Future Changes
As the Trump administration and Republican leadership in Congress begin a new term and seek to repeal the Affordable Care Act (ACA), a new 50-state survey from the Kaiser Family Foundation offers an in-depth profile of Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal, and cost sharing policies…
Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2017: Findings from a 50-State Survey
This 15th annual 50-state survey provides data on Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2017, and identifies changes in these policies in the past year. As discussion of repeal of the Affordable Care Act (ACA), broader changes to Medicaid, and reauthorization of CHIP unfolds, this report documents the role Medicaid and CHIP play for low-income children and families and the evolution of these programs under the ACA. The findings offer an in-depth profile of eligibility, enrollment, renewal, and cost sharing policies in each state as of January 2017, providing a baseline against which future policy changes may be measured.
What Are the Implications of Repealing the Affordable Care Act for Medicare Spending and Beneficiaries?
The 2010 Affordable Care Act (ACA) included many provisions affecting the Medicare program and the 57 million seniors and people with disabilities who rely on Medicare for their health insurance coverage. This brief explains the Medicare provisions in the ACA and explores the implications for Medicare and beneficiaries of repealing these provisions.
As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a…
Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services
This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.
This blog post revisits an earlier analysis of the drug Sovaldi (sofosbuvir) using new data released by the Centers for Medicare and Medicaid Services, and considers both the ongoing impact of hepatitis C drugs for Medicare Part D and the broader implications for Medicare of new high-priced drugs entering the market.
New Analysis Finds Out-of-Pocket Prescription Drug Spending Decreasing on Average, But More People Spending in Excess of $1,000 a Year
A new Kaiser Family Foundation analysis finds that average annual out-of-pocket prescription drug spending for workers and family members decreased from a recent high of $167 in 2009 to $144 in 2014. Most of the decline in out-of-pocket spending occurred between 2009 and 2012 and is likely due to generic…