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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.

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…

Where are States Today? Medicaid and CHIP Eligibility Levels for Children and Non-Disabled Adults as of April 1, 2014

The Affordable Care Act (ACA) creates new coverage options through Medicaid and new health insurance exchange marketplaces that, taken together, provide assistance to individuals with family incomes up to 400% of the federal poverty level (FPL). The ACA calls for the expansion of Medicaid eligibility to 138% FPL ($15,856 for an individual or $26,951 for a family of three in 2013) in 2014, which would make millions of adults newly eligible for the program. However, this expansion was effectively made a state option by the Supreme Court. If a state does not expand Medicaid, low-income uninsured adults in that state will not gain that new coverage option and will likely remain uninsured. This brief provides an overview of current Medicaid and CHIP eligibility levels for non-disabled children and adults to provide better insight into the impact of the Medicaid expansion.

How Will the Medicaid Expansion for Adults Impact Eligibility and Coverage?

Beginning in 2014, the Affordable Care Act (ACA) provides for the expansion of Medicaid eligibility to adults with incomes up to 138% FPL ($15,415 for an individual or $26,344 for a family of three in 2012), which would make millions of currently uninsured adults newly eligible for the program. The…

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…

The Impact of the Coverage Gap in States not Expanding Medicaid by Race and Ethnicity

The Affordable Care Act (ACA) expansion of Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL) effectively became a state option following the Supreme Court decision, creating a “coverage gap” for many poor uninsured adults in states that do not expand Medicaid. This brief examines this coverage gap by race and ethnicity.

State Health Insurance Marketplace Profiles

Up-to-date state profiles give an in-depth look at each state’s progress in setting up marketplaces, formally known as exchanges, including the legislative process and the next steps.