Filling the need for trusted information on national health issues…

President Donald Trump and GOP leaders in Congress have called for sweeping changes in health care policy, including the proposed American Health Care Act, which would repeal of the Affordable Care Act and its Medicaid expansion and a fundamentally change the way Medicaid is financed by establishing a per capita cap system. The Trump Administration also may consider and approve new waiver requests from state Medicaid programs. This page rounds up several of our most salient resources on Medicaid and the future of the nation’s public health insurance program for people with low income, which covers 74 million Americans. Medicaid covers a broad array of health services and limits enrollee out-of-pocket costs. The program is also the principal source of long-term care coverage for Americans. As the nation’s single largest insurer, Medicaid provides significant financing for hospitals, community health centers, physicians, and nursing homes, and jobs in the health care sector. The Medicaid program finances over 16% of all personal health care spending in the U.S..
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Key Themes in Section 1115 Medicaid Expansion Waivers

This issue brief focuses on Section 1115 waivers that implement the ACA’s Medicaid expansion and highlights themes in approved, pending, and denied provisions to date as well as key issues to watch looking ahead. Additional detail about each state’s waiver is provided in the Appendix tables.

Seven states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) currently are implementing the ACA’s Medicaid expansion through a Section 1115 demonstration waiver. The previous Administration denied Ohio’s waiver application. Two states (Kentucky and Indiana) currently have Medicaid expansion waivers pending before the Centers for Medicare and Medicaid Services (CMS).

Views of Governors and Insurance Commissioners on ACA Repeal and Changes to Medicaid: Responses to a Congressional Request for State Input on Health Reform

This brief summarizes responses from governors and insurance commissioners in 35 states, including DC, to a request from members in the House of Representatives for state input on health care reforms. These responses provide insight into state leaders’ views on repeal and replacement of the ACA and the changes Congress is considering making to the financing and structure of Medicaid. It finds that respondents have mixed views on the ACA and potential repeal and replacement of the ACA; most respondents expressed cautions or concerns about repeal, which are shared among both Republicans and Democrats and those who oppose and support appeal; more respondents expressed concerns about capped Medicaid financing than indicated support, and those that expressed support included significant caveats; less than half of respondents, mostly Republican, cited interest in increased state Medicaid flexibility; over half of respondents supported returning authority to states to regulate insurance markets; and few respondents expressed interest in allowing the sale of insurance across state lines, HSAs, or high risk pools.

Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion

As the 115th U.S. Congress deliberates the future of the Affordable Care Act, also known as Obamacare, an interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2016 ACA marketplace health plan and the political party of each district’s representative as of January. The analysis also includes maps charting the total number of people enrolled under the ACA Medicaid expansion in 2015 in states that implemented the ACA Medicaid expansion, along with the political parties of their governors and U.S. senators.

Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid

This month’s Kaiser Health Tracking Poll explores the public’s views on the changing landscape of the U.S. health care system including proposals to repeal and replace the Affordable Care Act (ACA) and to change Medicaid financing to a system of block grants or per capita allotments. The survey also examines which sources, including news media and other sources, the public trusts for information on the proposed changes to the country’s health care system.

Amid Repeal Debate, Public Views Obamacare More Favorably Than Unfavorably

Large Majorities Want to Continue Federal Funding for Medicaid Expansion; Two Thirds Favor Current Federal Role over Block Grants or Per-Capita Caps As President Trump and Congress weigh repealing the Affordable Care Act, the latest Kaiser Health Tracking Poll finds more Americans viewing the law favorably than unfavorably (48% compared…

Medicaid’s Role: What’s at Stake Under a Block Grant or Per Capita Cap?

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.

Data Note: Variation in Per Enrollee Medicaid Spending Across States

Proposals to transition Medicaid a block grant or per capita cap would reduce federal spending. To understand per capita cap proposals, it is helpful to understand variation in per enrollee spending and per enrollee spending growth across states and enrollment groups. A per capita cap policy could lock in historic variation. This data note uses interactive maps and tables to show variation in per enrollee spending and spending growth by state and eligibility group.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.