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The Henry J. Kaiser Family Foundation

The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid

The expansion of Medicaid eligibility under the Affordable Care Act (ACA) fills in historical gaps in coverage for adults and is a key piece of the continuum of new coverage options. However, in states that do not expand Medicaid, nearly five million poor uninsured adults have incomes above Medicaid eligibility levels but below poverty and may fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits.

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Webinar for Journalists on Medicaid and the Affordable Care Act: The Impact of State Decisions

This webinar includes a brief presentation on the law’s Medicaid expansion, where states stand on implementation, and the impact of state decisions on coverage and financing. The Foundation’s Medicaid experts also answer journalists’ questions.

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The Henry J. Kaiser Family Foundation

Aligning Eligibility for Children: Moving the Stairstep Kids to Medicaid

The Affordable Care Act (ACA) requires that Medicaid cover children with incomes up to 133 percent of the federal poverty level (FPL) ($31,322 for a family of four in 2013) as of January 2014. Today, there are “stairstep” eligibility rules for children. States must cover children under the age of six in families with income of at least 133 percent of the FPL in Medicaid while older children and teens with incomes above 100 percent of the FPL may be covered in separate state Children’s Health Insurance Programs (CHIP) or Medicaid at state option. While many states already cover children in Medicaid with income up to 133 percent FPL, due to the change in law, 21 states needed to transition some children from CHIP to Medicaid. This brief examines how the transition of children from CHIP to Medicaid will affect children and families as well as states. The brief also looks to New York and Colorado for lessons learned from the early transition of coverage.

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The Henry J. Kaiser Family Foundation

The Many Roads to Medicaid: An Overview of How People are Connecting to the Program Today

This brief provides an overview of the many different paths to enrollment in Medicaid and CHIP, including paths created under the Affordable Care Act (ACA), and reviews the available national level data on enrollment through these avenues.

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The Henry J. Kaiser Family Foundation

A Closer Look at The Uninsured Eligible for Medicaid and CHIP

This brief provides a closer look at the child and adult uninsured population eligible for Medicaid coverage under current and new ACA rules and identifies key differences between states moving forward with the expansion and those not moving forward at this time

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The Henry J. Kaiser Family Foundation

An Introduction to Medicaid and CHIP Eligibility and Enrollment Performance Measures

The Centers for Medicare & Medicaid Services (CMS) recently established 12 new Medicaid and CHIP eligibility and enrollment performance indicators for states to report beginning in October 2013. These indicators provide insight into the performance of new eligibility and enrollment policies established under the Affordable Care Act (ACA). In December 2013, CMS released initial reports for a subset of the indicators. This brief provides an overview of the new performance indicators; the initial data; and the opportunities and challenges associated with reporting, analyzing, and interpreting the data.

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The Henry J. Kaiser Family Foundation

The Cost of Not Expanding Medicaid

As states wrap up legislative sessions and make decisions about whether to implement the Medicaid expansion included in the Affordable Care Act (ACA), this new analysis highlights the implications of these decisions for coverage, state budgets and providers. The decisions by as many as 27 states not to adopt the Medicaid expansion will leave a many more uninsured; these states would also forgo billions in federal funds.

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The Henry J. Kaiser Family Foundation

Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal

This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.

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The Henry J. Kaiser Family Foundation

Analyzing the Impact of State Medicaid Expansion Decisions

One of the major vehicles in the Affordable Care Act (ACA) to increase health insurance coverage is an expansion of Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL). While the expansion was intended to be implemented in all states, as a result of the Supreme Court decision on the ACA, it is now effectively a state choice. States are divided about implementing the Medicaid expansion. This brief highlights 5 key ways that state decisions will shape the outcome of the Medicaid expansion. Without the Medicaid expansion there will be large gaps in coverage; significant implications for health care for the uninsured; consequences for certain regions and for people of color; coverage and fiscal implications for states, and implications for uncompensated care and hospitals.

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The Henry J. Kaiser Family Foundation

Managing a High Performing Medicaid Program

This report discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states face as they transform the way they do business and achieve key national goals. The paper relies on an extensive review of federal and state administrative responsibilities drawn from statute, regulation, and relevant literature, coupled with discussions with six current Medicaid directors.

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