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Performing Under Pressure: Annual Findings of a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP, 2011-2012

The annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost-sharing practices, conducted by the Kaiser Commission on Medicaid and the Uninsured with the Georgetown University Center for Children and Families, found that, despite continued fiscal pressures on states, eligibility policies remained stable in nearly…

Health Insurance Market Reforms: Pre-Existing Condition Exclusions

Insurers pursue multiple strategies to reduce the cost of covering enrollees with pre-existing conditions, or medical conditions and health problems that existed before the individual enrolled in a health plan. One strategy, the pre-existing condition exclusion, allows insurers to refuse to cover any costs associated with care for a pre-existing…

Health Reform and the Art of Federalism

The U.S. Department of Health and Human Services (HHS) recently announced significant changes to the premiums charged in the Pre-existing Condition Insurance Plan (PCIP), aka the “high risk pool” created by the Affordable Care Act. Premiums will now be up to 40% lower depending on the state (in some states…

CBO’s Estimate of Repealing Exchange Grants: The Importance of Being Effective

The Congressional Budget Office (CBO) recently released an analysis of a bill that would repeal grants to states under the health reform law to help them establish health insurance purchasing exchanges. Not surprisingly, CBO finds that the bill would reduce federal spending due to the fact that expected grants won’t…

Getting into Gear for 2014: Shifting New Medicaid Eligibility and Enrollment Policies into Drive

On January 1, 2014, many key provisions of the Affordable Care Act (ACA) will start to go into effect, including the expansion of Medicaid to low-income adults and the launch of new Medicaid eligibility and enrollment processes, which are designed to move toward a coordinated enrollment system across health coverage programs, including Medicaid, CHIP, and the new Health Insurance Marketplaces. Over the past year, states have made steady and significant progress preparing for these changes, but readiness varies considerably as 2014 nears, and implementation work and ongoing process improvements will continue into the foreseeable future. To provide greater insight into the status of implementation, this report provides an overview of key state Medicaid eligibility and enrollment policies slated to go into effect based on data released by the Centers for Medicare and Medicaid Services (CMS).

Medicaid Enrollment: June 2012 Data Snapshot

This issue brief updates our monthly Medicaid enrollment figures to include data as of June 2012. The issue brief discusses enrollment trends across all 50 states and DC as well as within select groups such as Families, the Aged & Disabled, as well as adult expansions (largely focusing on adults without dependent children or childless adults).

CHIP Enrollment: June 2012 Data Snapshot

This issue brief updates monthly enrollment data for the Children’s Health Insurance Program (CHIP) across all 50 states and DC to include June 2012 data.

Medicaid Eligibility for Adults as of January 1, 2014

Regardless of state Medicaid expansion decisions, all states must implement new eligibility and enrollment processes, including a transition to determine income eligibility for most groups based on Modified Adjusted Gross Income (MAGI). As part of the transition to MAGI, states’ existing Medicaid income limits for children, pregnant women, parents, and childless adults will be converted to MAGI-equivalent limits. This fact sheet provides Medicaid income limits for parents and childless adults as of January 2013, and the new income limits that will be in effect as of January 1, 2014.