Policymakers are currently considering proposals that would fundamentally change the structure and financing of Medicaid, and potentially affect 11 million people on Medicare. This brief discusses the potential implications of Medicaid per capita cap or block grant proposals for the 11 million low-income seniors and people with disabilities on Medicare. It also describes how the per capita cap model proposed in the American Health Care Act could potentially affect low-income people on Medicare who receive assistance from Medicaid.
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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The proposed American Health Care Act (AHCA) includes a state option to make Medicaid eligibility for nondisabled, nonelderly, non-pregnant adults conditional upon satisfaction of a work requirement. Although the Centers for Medicare and Medicaid Services denied all state Section 1115 waiver requests to institute such work requirements under the Obama…
Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US
This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.
This issue brief reviews the current status of states’ Section 1115 waiver requests relating to Medicaid work requirements and identifies key policy questions to consider in terms of the impact on beneficiaries, states, and other stakeholders.
In this analysis, we present three scenarios of reductions in federal Medicaid spending and examine fiscal implications if states fill these financing gaps to maintain their programs and if all reductions are assumed to be in full effect in FFY 2015 (the most recent year for which Medicaid spending data is available). To fill these gaps in financing and maintain current Medicaid programs, we assume states will increase state spending for Medicaid by increasing state taxes or reducing education spending. This analysis is unlike the CBO estimate, which makes projections and accounts for changes in policy, state responses to make changes to Medicaid programs, and reductions in coverage.
11 Million People on Medicare Are Also Covered by Medicaid. What Could Switching to a Medicaid Per Capita Cap Mean for Them?
A major structural change to Medicaid financing such as the per capita cap system called for under the American Health Care Act could have significant implications for the 11 million seniors and people with disabilities who are covered by both Medicare and Medicaid, according to a new brief by the…
This infographic provides information and statistics about the opioid epidemic and Medicaid’s role in covering addiction treatment services.
Who Are the 7 Million Nonelderly Adults with Disabilities in Medicaid and What Would the House GOP Bill to Restructure Medicaid Financing and Repeal the Affordable Care Act Mean for Them?
A new brief from the Kaiser Family Foundation explains the role that Medicaid plays for nearly 7 million nonelderly adults with disabilities in the U.S. and explores what the American Health Care Act could mean for their health care and coverage. Medicaid covers more than three in 10 nonelderly adults…
This brief describes Medicaid’s role for nearly 7 million nonelderly adults with disabilities living in the community to help inform the debate about the American Health Care Act’s proposals to end enhanced federal funding under the ACA and reduce federal Medicaid funding under a per capita cap.
On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected under current law, and 14 million fewer people would be covered by Medicaid than expected under current law. This brief considers five key Medicaid implications of the House bill.