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The Henry J. Kaiser Family Foundation

Health Insurance Market Reforms: Guaranteed Issue

Guaranteed issue laws require insurance companies to issue a health plan to any applicant – an individual or a group – regardless of the applicant’s health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical…

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The Henry J. Kaiser Family Foundation

Characteristics of Uninsured Low-Income Adults

Effective January 2014, the Affordable Care Act establishes a new minimum Medicaid eligibility level of 138 percent of poverty for non-disabled adults who were not previously eligible for the program. As with current Medicaid, legal immigrants who have been in the country for five years or fewer are not eligible…

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The Henry J. Kaiser Family Foundation

The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis

A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. Following the June 2012 Supreme Court decision, states face a decision about whether to adopt…

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The Henry J. Kaiser Family Foundation

Health Insurance Market Reforms: Rate Review

Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the…

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The Henry J. Kaiser Family Foundation

Coverage of Preventive Services for Adults in Medicaid

This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to…

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The Henry J. Kaiser Family Foundation

Why Does Medicaid Spending Vary Across States: A Chartbook of Factors Driving State Spending

This detailed chartbook provides an illustrative overview of some of the key factors that contribute to the substantial variation in Medicaid spending across states today. The chartbook provides a broad range of state-by-state data on subjects including state revenue and spending, the demand for public services, health care markets, and…

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The Henry J. Kaiser Family Foundation

Where Are States Today? Medicaid and CHIP Eligibility Levels for Adults, Children, and Pregnant Women as of January 2015

This fact sheet provides an overview of eligibility levels for parents, other non-disabled adults, children, and pregnant women in Medicaid and CHIP as of January 2015, one year after key Medicaid provisions in the Affordable Care Act (ACA) took effect. The findings highlight Medicaid’s expanded role for low-income adults under…

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The Henry J. Kaiser Family Foundation

State High-Risk Pools: An Overview

Health reform bills passed in the House and Senate would create a national high-risk pool insurance program to offer health coverage to otherwise uninsurable individuals during the interim period between the enactment of legislation and the implementation of broader health care reform. This issue brief discusses the structure, operation, benefits…

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The Henry J. Kaiser Family Foundation

Medicaid Coverage and Spending in Health Reform: National and State-By-State Results for Adults at or Below 133% FPL

This analysis, performed by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, shows that the expansion of Medicaid under the health reform law will significantly increase the number of people covered by the program and reduce the uninsured in states across the country, with the federal…

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The Henry J. Kaiser Family Foundation

How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees

This brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will…

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