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Medicaid Reforms to Expand Coverage, Control Costs and Improve Care: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2015 and 2016

This report provides an in depth examination of the changes taking place in state Medicaid programs across the country. The findings in this report are drawn from the 15th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), with the support of the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2015 and those planned for implementation in FY 2016 based on information provided by the nation’s state Medicaid Directors. Key areas covered include changes in eligibility and enrollment, delivery and payment system reforms, provider payment rates, and covered benefits (including prescription drug policies).

What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2016

This Issue Brief examines the availability of Medicare Advantage plans nationwide and by state in 2016, and tracks changes in plan availability since 2012. It documents the number and share of Medicare Advantage enrollees affected by plan withdrawals each year, the characteristics of plans that will be entering or exiting the market in 2016, and the potential implications of these changes for Medicare Advantage enrollees.

The Affordable Care Act Drove Record Annual Increases in Enrollment and Total Medicaid Spending Nationally in FY 2015, As Newly Eligible Adults gained Coverage in Expansion States

High Federal Match for Adult Expansion Group Contributed to Substantially Slower State Medicaid Spending Growth in Expansion States Compared to Non-Expansion States Survey Also Finds States Relying More on Managed Care, Undertaking Delivery System Reforms The Affordable Care Act’s Medicaid expansion resulted in record increases in Medicaid enrollment and spending…

The ACA and People with HIV: Profiles from the Field

New in-depth profiles of 12 people with HIV highlight how the Affordable Care Act’s coverage expansions impacted their access to coverage and care. While some experienced serious bumps along the way, those who gained coverage through Medicaid and the Marketplaces were largely able to meet both their HIV and non-HIV care…

Children’s Coverage: What Matters Most to Parents Results from Focus Groups in 6 Cities

This report is based on based on focus group discussions with parents with moderate incomes enrolled in private coverage (employer sponsored or Marketplace) who had children in public coverage (primarily CHIP) or children with private coverage. This report is based on 14 focus group discussions conducted by the Kaiser Family Foundation and John Snow, Inc. in six cities during February and March 2015. Sites included Birmingham, AL, Chicago, IL, Denver, CO, Philadelphia, PA, and Tampa, FL. Each of these states operate separate CHIP programs. An additional 4 focus groups were conducted in Los Angeles, CA (two in English and two in Spanish). The purpose of the groups was to gain insight into what low and middle-income families value in their children’s coverage, their experiences with CHIP and private insurance, and on parents’ perspectives on the future of CHIP. The information gathered can help inform policy questions such as would private coverage (either employer sponsored coverage or Marketplace) or Medicaid work for children who currently are enrolled in CHIP?

Data Note: Medicare Advantage Enrollment, by Firm, 2015

A number of potential mergers and acquisitions between large firms that offer health insurance have been reported in the press. These mergers could affect consumers in the individual market, enrollees in the new federal and state Marketplaces, employees with employer-sponsored insurance, as well as people covered by public programs such as Medicare. This Data Note examines the Medicare Advantage market share of large firms that have reportedly engaged in merger and acquisition discussions: Aetna, Anthem, Cigna, Humana, and UnitedHealthcare.

Recent Trends in Medicaid and CHIP Enrollment as of January 2015: Early Findings from the CMS Performance Indicator Project

Building on earlier work examining the Performance Indicator Project, this is an updated analysis examining recent trends in Medicaid and CHIP eligibility and enrollment. As of January 2015, 70.0 million people were enrolled in Medicaid or CHIP. Nearly two-thirds of enrollees resided in states that have implemented the Medicaid expansion. Between Summer 2013 and January 2015, there was a net increase of nearly 11.2 million people enrolled in Medicaid and CHIP; states that expanded Medicaid experienced significantly greater net Medicaid and CHIP enrollment growth than states that have not expanded. Children account for a greater share of total Medicaid and CHIP enrollment in nearly all states that have not expanded Medicaid compared to states that have expanded.

The California Health Care Landscape

This fact sheet provides an overview of population health, health coverage, and the health care delivery system in California in the era of health reform.

Medicaid Enrollment: June 2013 Data Snapshot

This Data Snapshot provides 50-state data on Medicaid monthly enrollment trends, adding June 2013 data. Overall, Medicaid enrollment growth continued to slow to the lowest rate since the start of the Great Recession as the economic conditions continued to slowly improve. While enrollment growth rates have been trending downward as economic conditions continue to slowly improve, enrollment growth is expected to increase significantly as states implement the ACA. Regardless of whether states decide to implement the Medicaid expansion or not, enrollment is anticipated to grow on average across all states due to new streamlined eligibility and enrollment processes as well as outreach for new coverage. This report provides baseline data for understanding the impact of the ACA eligibility and enrollment policies on enrollment growth across states.

CHIP Enrollment: June 2013 Data Snapshot

This issue brief provides state level CHIP enrollment data, adding the June 2013 period. In June 2013, over 5.7 million children were enrolled in the Children’s Health Insurance Program (CHIP.) Enrollment in June 2013 increased by 190,453 or by 3.4 percent, compared to one year earlier. Since 2009, annual rates of growth have remained fairly steady, ranging between 3.2 percent and 3.8 percent. In contrast, during the height of the Great Recession, enrollment increased annually by 7.8 to 10 percent. Overall, CHIP enrollment continued to increase, but growth slow to the lowest rates since the start of the Recession as the economic conditions continued to improve. CHIP programs, along with state Medicaid programs continue to play a critical role in assuring health coverage for uninsured children.

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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.