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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.

Medicaid Eligibility for Adults as of January 1, 2014

Regardless of state Medicaid expansion decisions, all states must implement new eligibility and enrollment processes, including a transition to determine income eligibility for most groups based on Modified Adjusted Gross Income (MAGI). As part of the transition to MAGI, states’ existing Medicaid income limits for children, pregnant women, parents, and childless adults will be converted to MAGI-equivalent limits. This fact sheet provides Medicaid income limits for parents and childless adults as of January 2013, and the new income limits that will be in effect as of January 1, 2014.

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.

Getting into Gear for 2014: Shifting New Medicaid Eligibility and Enrollment Policies into Drive

On January 1, 2014, many key provisions of the Affordable Care Act (ACA) will start to go into effect, including the expansion of Medicaid to low-income adults and the launch of new Medicaid eligibility and enrollment processes, which are designed to move toward a coordinated enrollment system across health coverage programs, including Medicaid, CHIP, and the new Health Insurance Marketplaces. Over the past year, states have made steady and significant progress preparing for these changes, but readiness varies considerably as 2014 nears, and implementation work and ongoing process improvements will continue into the foreseeable future. To provide greater insight into the status of implementation, this report provides an overview of key state Medicaid eligibility and enrollment policies slated to go into effect based on data released by the Centers for Medicare and Medicaid Services (CMS).

Fast Track to Coverage: Facilitating Enrollment of Eligible People into the Medicaid Expansion

To help states launch the Affordable Care Act (ACA) Medicaid expansion and efficiently enroll eligible individuals, CMS has offered states a series of facilitated enrollment options. These options include strategies, referred to as “fast track enrollment” in this issue brief, that allow states to enroll eligible individuals into coverage using data already available from their Supplemental Nutrition Assistance programs (SNAP) and/or their Medicaid or Children’s Health Insurance Program (CHIP) programs for children. This issue brief provides an overview of the new “fast track” enrollment options, including how they have been implemented, their impacts, and key lessons learned. It is based on a series of interviews with state officials in Arkansas, Illinois, Oregon and West Virginia conducted by Manatt Health Solutions and the Kaiser Commission on Medicaid and the Uninsured in October 2013.

The Affordable Care Act’s Impact on Medicaid Eligibility, Enrollment, and Benefits for People with Disabilities

Medicaid is an important source of health insurance coverage for people with disabilities. This issue brief explains how Medicaid eligibility and benefits for people with disabilities are affected by the Affordable Care Act (ACA) rules as of 2014. Marketplace rules are discussed to the extent that they relate to Medicaid eligibility determinations for people with disabilities.

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.