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Medicaid in a Crunch: A Mid-FY 2009 Update on State Medicaid Issues in a Recession

This report relays the perspective of leading state Medicaid directors to describe the fiscal strain on Medicaid and other safety-net programs as enrollment swells and state tax revenues shrink, raising the prospect of program cutbacks. It draws on focused interviews with leading Medicaid directors in November 2008. It augments the…

A Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage

This historical review finds that the availability of federal funds has served as an effective incentive for states to provide health coverage to meet the health and long-term care needs of their low-income residents despite state budget pressures. The brief examines the history of earlier experiences and provides important context for how states may respond as they weigh the costs and benefits of expanding their Medicaid programs in 2014 as called for under the Affordable Care Act.

Implications Of A Federal Block Grant Program For Medicaid

This issue brief examines the broad implications of converting Medicaid to block grant financing, one of several ideas that have been put forth to help reduce the federal deficit. The paper, which does not analyze any specific proposal, notes that switching to block grant financing would fundamentally alter the Medicaid…

Enhanced Medicaid Match Rates Expire in June 2011

This fact sheet discusses the role played by the enhanced federal Medicaid matching funds available to states through the American Recovery and Reinvestment Act of 2009 (ARRA), and the implications for state Medicaid programs as that extra assistance expires June 30, 2011. States used the ARRA enhanced Medicaid funding to…

Medicaid Enrollment and Expenditures by Federal Core Requirements and State Options

To receive federal Medicaid matching funds, states that participate in Medicaid must meet federal requirements, which include covering specified “federal core” enrollee groups and mandatory health benefits. States also may choose to cover additional “state expansion” enrollees and optional benefits with federal Medicaid matching funds. The federal core eligibility standards…

Designing a Marketplace that Works: Steps to Affordable Coverage

The Affordable Care Act enacted in March 2010 calls for the establishment of state health insurance exchanges — marketplaces through which individuals and small businesses can purchase affordable insurance. These exchanges must begin operation by January 1, 2014. This October 22 briefing, cosponsored by the Alliance for Health Reform and…

Medicaid and CHIP Coverage In An Era of Recession and Health Reform

Despite tight budgets, nearly all states maintained or made targeted expansions or improvements in their Medicaid and Children’s Health Insurance Programs (CHIP) eligibility and enrollment rules in 2010, preserving the programs’ important role of providing coverage to millions of low-income Americans who otherwise lack affordable options. This stability in large…

Medicaid Spending Growth and the Great Recession, 2007-2009

This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending. Fact Sheet (.pdf)

Medicaid Financing: An Overview of the Federal Medicaid Matching Rate (FMAP)

Since its enactment in 1965, the Medicaid program has used the Federal Medical Assistance Percentage (FMAP) to determine the federal government’s share of the cost of covered services in state Medicaid programs. On average, the federal share has been 57 percent. Beginning in 2014, the Affordable Care Act (ACA) establishes…

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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.