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The ACA and Medicaid Expansion Waivers

This brief focuses on Section 1115 Medicaid demonstration waivers related to implementation of the ACA Medicaid expansion (eligible for ACA enhanced matching funds) or other coverage (not eligible for ACA enhanced matching funds). To date, six states are currently implementing or planning to implement the Medicaid expansion through an approved Section 1115 Waiver (Arkansas, Iowa, Michigan, Indiana, New Hampshire, and Montana). New Hampshire and Montana will be effective in January 2016. Pennsylvania received waiver approval, but transitioned to a state plan amendment in mid-2015, so Pennsylvania is not included in the discussion of current and pending waivers.
In addition, two states currently have waiver proposals pending with CMS: Arizona and Michigan. Arizona implemented the expansion, but is now seeking changes based on state law. Michigan has a pending waiver amendment seeking changes required by state law to continue its expansion after April 2016.

Putting Medicaid in the Larger Budget Context: An In-Depth Look at Three States in FY 2015 and 2016

This report provides an in-depth examination of Medicaid program changes in the larger context of state budgets in three states: Alaska, California, and Tennessee. These case studies build on findings 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).

The State Innovation Models (SIM) Program: A Look at Round 2 Grantees

This fact sheet provides information about the grants awarded under Round 2 of the State Innovation Models (SIM) initiative, with a focus on Model Test grants. Key themes are identified as well as similarities and differences among state approaches. Eleven states – Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington — received Model Testing awards to implement and test their Innovation Plans over 48 months.

Proposed Medicaid Expansion in Tennessee

This fact sheet describes Tennessee’s 1115 waiver demonstration project, Insure Tennessee, which expands the State’s Medicaid program under the Affordable Care Act.

Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.

Tennessee’s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model

Tennessee’s Money Follows the Person (MFP) demonstration, implemented within the context of Tennessee’s pre-existing capitated Medicaid managed care delivery system, is an integral component of the state’s Medicaid long-term services and supports rebalancing efforts. This case study describes key features of Tennessee’s MFP demonstration and highlights recent program experiences.

How Will the Uninsured in Tennessee Fare Under the Affordable Care Act?

This state report explains how the ACA expands coverage in Tennessee, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Tennessee are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

State Exchange Profiles: Tennessee

Updated as of December 10, 2012 Establishing the Exchange On December 10, 2012, Governor Bill Haslam (R) announced Tennessee would default to a federally-facilitated health insurance exchange.1 Prior to the announcement that the state would not operate its own exchange, the Tennessee Department of Finance and Administration established the Insurance…

Managed Care and Low-Income Populations: A Case Study of Managed Care in Tennessee

TennCare represents one of the most ambitious state-level efforts to restructure Medicaid and expand insurance coverage to the uninsured. The case study shows that the rapid change caused considerable confusion for patients, providers, and health plans. The TennCare experience provides early insights into the issues that states will face as they move to enroll more of their low-income populations into managed care arrangements.