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
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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.
For 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed care and delivery system reforms collected as part of this annual survey. Looking ahead, the survey will continue to capture the evolution of the Medicaid program with a focus program changes during economic cycles as well as innovations in payment and delivery system reform.
A Comprehensive Review of Research Finds That the ACA Medicaid Expansion Has Reduced the Uninsured Rate and Increased Access to Care in Expansion States
Multiple studies find that the Affordable Care Act’s Medicaid expansion has increased coverage, with enrollment exceeding expectations in some states, while producing budget savings for states and reductions in uncompensated care costs for hospitals, according to a Kaiser Family Foundation review of 61 studies and policy reports. The literature review provides…
Research on the effects of Medicaid expansions under the Affordable Care Act (ACA) can help increase understanding of how the ACA has impacted coverage; access to care, utilization, and health outcomes; and various economic outcomes, including state budgets, the payer mix for hospitals and clinics, and the employment and labor market. These findings also may inform ongoing debates surrounding the Medicaid expansion. This brief reviews and summarizes findings from a total of 61 studies of the impact of state Medicaid expansions under the ACA.
This survey of Kentucky residents gauges their views on health care policy in the state, including their preferences for the future of the Medicaid expansion and the state-based health insurance marketplace, Kynect. Kentucky has received national attention as the only Southern state to fully embrace the Affordable Care Act, though the state elected a new governor in November 2015 who campaigned on rolling back the Medicaid expansion and ending Kynect.
Half of Kentucky Residents Hold Unfavorable Views of the Affordable Care Act, But Seven in Ten, Including Most Republicans, Don’t Want to Scale Back Medicaid Expansion to Cover Fewer People
Half of Residents Want to Keep the State’s Insurance Marketplace Kynect, While a Quarter Favor Switching to Federal Healthcare.Gov Marketplace Instead Many Believe Coverage Expansions Have a Negative Impact on the State’s Budget A Kaiser Family Foundation poll of Kentucky residents finds that after much discussion of the issue in…
Medicaid in a Time of Growth and Change: Findings from the Annual Kaiser 50-State Medicaid Budget Survey at a Forum with the National Association of Medicaid Directors
The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) released its 15th annual 50-state Medicaid budget survey for state fiscal years 2015 and 2016. Kaiser and the National Association of Medicaid Directors (NAMD) held a joint briefing to discuss key findings and highlight trends in enrollment and spending as well as policy changes in Medicaid programs around the country.
The Affordable Care Act Drove Record Annual Increases in Enrollment and Total Medicaid Spending Nationally in FY 2015, As Newly Eligible Adults gained Coverage in Expansion States
High Federal Match for Adult Expansion Group Contributed to Substantially Slower State Medicaid Spending Growth in Expansion States Compared to Non-Expansion States Survey Also Finds States Relying More on Managed Care, Undertaking Delivery System Reforms The Affordable Care Act’s Medicaid expansion resulted in record increases in Medicaid enrollment and spending…
This report provides an in-depth examination of Medicaid program changes in the larger context of state budgets in three states: Alaska, California, and Tennessee. These case studies build on findings from the 15th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA).