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What Could a Medicaid Per Capita Cap Mean for Low-Income People on Medicare?

Policymakers are currently considering proposals that would fundamentally change the structure and financing of Medicaid, and potentially affect 11 million people on Medicare. This brief discusses the potential implications of Medicaid per capita cap or block grant proposals for the 11 million low-income seniors and people with disabilities on Medicare. It also describes how the per capita cap model proposed in the American Health Care Act could potentially affect low-income people on Medicare who receive assistance from Medicaid.

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The Henry J. Kaiser Family Foundation

Brief Examines State Requests to Impose Work Requirements in Medicaid

The proposed American Health Care Act (AHCA) includes a state option to make Medicaid eligibility for nondisabled, nonelderly, non-pregnant adults conditional upon satisfaction of a work requirement. Although the Centers for Medicare and Medicaid Services denied all state Section 1115 waiver requests to institute such work requirements under the Obama…

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The Henry J. Kaiser Family Foundation

Most States Would Have Seen Declines in Federal Medicaid Funds from 2001 to 2011 Under a Per Enrollee Spending Cap Limiting Growth to Medical Inflation

A new analysis from the Kaiser Family Foundation finds that the majority of states would have gotten less in federal Medicaid funding from 2001 to 2011 if Medicaid financing had been based on a per capita cap. The analysis looked at what would have happened if spending growth per Medicaid…

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The Henry J. Kaiser Family Foundation

Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.

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Medicaid and Work Requirements

This issue brief reviews the current status of states’ Section 1115 waiver requests relating to Medicaid work requirements and identifies key policy questions to consider in terms of the impact on beneficiaries, states, and other stakeholders.

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Data Note: Three Findings about Access to Care and Health Outcomes in Medicaid

The Medicaid program covers 74 million low-income Americans, including many of the poorest and sickest people in our society. Among those served are pregnant women and children, parents and other adults, poor seniors, and people with disabilities. Given Medicaid’s major coverage role and the complex needs of the populations it covers, data and evidence on access to care and health outcomes in Medicaid are of key interest. Such an assessment is also important to ensure that debate about the effectiveness of the Medicaid program is grounded in facts and analysis. This Data Note discusses what the research shows.

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Data Note: What if Per Enrollee Medicaid Spending Growth Had Been Limited to CPI-M from 2001-2011?

Congress is currently debating the American Health Care Act (AHCA), which would repeal and replace the Affordable Care Act (ACA) and also make substantial changes to the structure and financing of Medicaid. Among other provisions, the AHCA would use a per capita cap policy to cap federal funds to states for Medicaid. This data note examines what the implications of tying per enrollee growth to CPI-M would have been for the 2001-2011 period for federal spending nationally and state-by-state by major enrollment group. This analysis is meant to illustrate how actual spending compares to spending limits that would have been in place if growth rates had been limited to CPI-M, similar to the limits proposed by the AHCA.

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Implications of Reduced Federal Medicaid Funds: How Could States Fill the Funding Gap?

In this analysis, we present three scenarios of reductions in federal Medicaid spending and examine fiscal implications if states fill these financing gaps to maintain their programs and if all reductions are assumed to be in full effect in FFY 2015 (the most recent year for which Medicaid spending data is available). To fill these gaps in financing and maintain current Medicaid programs, we assume states will increase state spending for Medicaid by increasing state taxes or reducing education spending. This analysis is unlike the CBO estimate, which makes projections and accounts for changes in policy, state responses to make changes to Medicaid programs, and reductions in coverage.

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The Henry J. Kaiser Family Foundation

11 Million People on Medicare Are Also Covered by Medicaid. What Could Switching to a Medicaid Per Capita Cap Mean for Them?

A major structural change to Medicaid financing such as the per capita cap system called for under the American Health Care Act could have significant implications for the 11 million seniors and people with disabilities who are covered by both Medicare and Medicaid, according to a new brief by the…

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Medicaid's Role in Addressing the Opioid Epidemic - thumbnail

Medicaid’s Role in Addressing the Opioid Epidemic

This infographic provides information and statistics about the opioid epidemic and Medicaid’s role in covering addiction treatment services.

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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.