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Essential Health Benefits: Balancing Affordability and Adequacy

Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets – will be required to cover a set of health benefits and services called the “essential health benefits” package. Guidance issued…

National ADAP Monitoring Project, Annual Report, 2006

The National ADAP Monitoring Report, 2006 provides the latest data on state AIDS Drug Assistance Programs (ADAPs). ADAPs, authorized under Title II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, provide HIV/AIDS-related prescription drugs to uninsured and underinsured individuals living with HIV/AIDS. ADAPs operate in 57 U.S. states,…

From Crunch to Crisis: State Budgets, Medicaid and the Economy

Medicaid programs are feeling the strain as enrollment grows while state revenues come in lower than projected. How are Medicaid directors coping? How is the recession affecting low-income individuals and families? This briefing, cosponsored by the Alliance for Health Reform and the Kaiser Commission on Medicaid and the Uninsured, addressed…

Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with…

States Getting a Jump Start on Health Reform’s Medicaid Expansion

One of the primary goals of the Affordable Care Act (ACA) is to decrease the number of uninsured through a Medicaid expansion to nearly all individuals with incomes up to 133 percent of the federal poverty level (FPL) ($14,856 for an individual or $25,390 for a family of three in…

A Focus Group with Medicaid Directors: As FY 2012 Ends, Looking Toward FY 2013

This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country. The discussion focused on state fiscal conditions, Medicaid…

Program Integrity in Medicaid: A Primer

Medicaid covers more than 60 million Americans and accounts for about one in six dollars spent on health care in the United States. Multiple agencies at the state and federal levels are involved in efforts to prevent waste, fraud and abuse in the program and ensure appropriate use of taxpayer…

State Financing of the Medicare Drug Benefit:  New Data on the “Clawback”

State Financing of the Medicare Drug Benefit: New Data on the “Clawback”Beginning in 2006, states will be obligated to finance part of the new Medicare prescription drug benefit via a monthly “clawback” payment to the federal government. This issue update analyzes the latest data and provides an overview of the…