Medicaid represents $1 out of every $6 spent on health care in the US and is the major source of financing for states to provide coverage to meet the health and long-term needs of their low-income residents. Medicaid is administered by states within broad federal rules and jointly funded by states and the federal government. President-elect Trump and other GOP proposals have put forth fundamental changes in Medicaid financing. This brief examines the following 3 key Medicaid financing questions: How does Medicaid financing work now?; How much does Medicaid cost and how are funds spent?; What is the role of Medicaid in federal and state budgets?
Featured Medicaid’s Future Resources
The Medicaid program covers 1 in 5 Americans, including many with complex and costly health and long-term care needs. Most Medicaid beneficiaries would be uninsured or underinsured without it. President Trump and other GOP leaders have called for major changes to Medicaid, including caps on federal funding. In the debate, some Medicaid critics have made statements that are at odds with data, research, and basic information about Medicaid. This brief highlights 10 facts about Medicaid to inform policy that may have significant implications for the program.
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Related Medicaid’s Future Resources
- Restructuring Medicaid in the American Health Care Act: Five Key Considerations
- Data Note: Medicaid’s Role in Providing Access to Preventive Care for Adults
- No, Medicaid Isn’t Broken
- 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?
- Data Note: Three Findings about Access to Care and Health Outcomes in Medicaid
- Data Note: Variation in Per Enrollee Medicaid Spending Across States
- Medicaid Waiver Requests in Wisconsin and Maine Seek to Impose Work Requirements and Time Limits for Beneficiaries
- The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
- What Coverage and Financing is at Risk Under a Repeal of the ACA Medicaid Expansion?
- Medicaid Restructuring Under the American Health Care Act and Nonelderly Adults with Disabilities
- Medicaid and Children with Special Health Care Needs
- Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US
- What Could a Medicaid Per Capita Cap Mean for Low-Income People on Medicare?
- Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion
- Expansion states are split between Republican and Democratic governors as of January 2017.
- Medicaid’s Role in Addressing the Opioid Epidemic
- Medicaid’s Role for Individuals with HIV
- Current Flexibility in Medicaid: An Overview of Federal Standards and State Options
- Medicaid and Work Requirements
- Key Themes in Section 1115 Medicaid Expansion Waivers
- Governors’ Proposed Budgets for FY 2018: Focus on Medicaid and Other Health Priorities
- Views of Governors and Insurance Commissioners on ACA Repeal and Changes to Medicaid: Responses to a Congressional Request for State Input on Health Reform
- 5 Key Questions: Medicaid Block Grants & Per Capita Caps
- 3 Key Questions: Section 1115 Medicaid Demonstration Waivers
- Data Note: Medicaid Managed Care Growth and Implications of the Medicaid Expansion
- Medicaid State Fact Sheets
- Key Issues in Children’s Health Coverage
- Medicaid Pocket Primer
- Medicaid Financing: The Basics
This video provides an overview of the people covered by Medicaid and how Medicaid funds are distributed across enrollment groups and on a per enrollee basis. The video also highlights the implications of reducing federal Medicaid funds through a block grant or per capita cap.
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This issue brief examines the changes in coverage and financing that have occurred under the Affordable Care Act’s (ACA) Medicaid expansion to provide insight into the potential scope of coverage and funding that may be at risk under a repeal of the law.
In this Wall Street Journal Think Tank column Drew Altman discusses how Republicans will assume ownership of health care’s policy and political problems as they assume control, and how that may affect their plans for the Affordable Care Act, Medicaid and Medicare.
This new fact sheet examines key questions around the potential changes President-elect Donald Trump and the next Congress may seek to make in Medicaid, a program that covers 73 million people nationally. Depending on how it is structured, a repeal of the Affordable Care Act could reverse the expansion of…
This fact sheet provides insight into how a repeal of the Affordable Care Act (ACA) and changes in the financing structure would affect Medicaid, including the Medicaid expansion, and how a Trump administration could change Medicaid through administrative actions.
This column was published as a Wall Street Journal Think Tank column on November 21, 2016. Early media coverage of the Republican health-care agenda has concentrated on plans to repeal and then replace the Affordable Care Act. The larger story is GOP preparations for a health policy trifecta: to fundamentally change the…
On June 22, 2016, Governor Bevin released his proposed Section 1115 demonstration waiver application called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) as an alternative to the current Medicaid expansion which is being implemented through a state plan amendment according to the terms in the ACA. This fact sheet summarized the proposed changes to the current Medicaid expansion in Kentucky.
Issue brief provides an overview of how a per capita cap financing structure could work, including implications for the federal government, state governments, beneficiaries and health care providers
The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per capita cap or block grant have been proposed before. Such changes represent a fundamental change in the financing structure of the program with major implications for beneficiaries, providers, states and localities. Key things to understand about a per capita cap include the following: how a per capita cap works, key design challenges, and implications of a per capita cap.
The Medicaid program is jointly funded by states and the federal government. There has been renewed interest in how Medicaid is financed in light of the additional federal financing for the Medicaid expansion under the Affordable Care Act (ACA) as well as ongoing budget discussions at the federal level. This brief reviews how the Medicaid program is financed as well as the implications for budgets, responsiveness to state policy choices and need, the links between Medicaid spending and state economies.