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Medicaid Moving Forward

Medicaid is the nation’s main public health insurance program for people with low incomes, and it is the single largest source of health coverage in the U.S. At last count, Medicaid covered over 68 million Americans – more than 1 in every 5 – at some point during the year and finances 16% of total personal health spending in the U.S. States design and administer their own Medicaid programs within federal requirements, and states and the federal government finance the program jointly. As a major payer, Medicaid is a core source of financing for safety-net hospitals and health centers that serve low-income communities, including many of the uninsured. It is also the main source of coverage and financing for both nursing home and community-based long-term care.

Medicaid Home and Community-Based Services Programs: 2011 Data Update

This report summarizes the key participation and spending trends in 2011 for the three main Medicaid Home and Community-Based Services (HCBS) programs – (1) the mandatory home health services state plan benefit, (2) the optional personal care services state plan benefit, and (3) optional § 1915(c) HCBS waiver services. Also highlighted are 2013 state eligibility, enrollment, and provider reimbursement policies.

Medicaid Expansion in Red States

In this column for The Wall Street Journal’s Think Tank, Drew Altman explains that Tennessee Gov. Bill Haslam’s decision on Medicaid expansion via the Affordable Care Act is the latest sign of pragmatism slowly winning over ideology in red states.

Web Briefing: Early Impacts of the Medicaid Expansion for the Homeless Population

The Affordable Care Act’s Medicaid expansion provides a significant opportunity to increase health coverage and improve access to care for individuals experiencing homelessness, who historically have had high uninsured rates and often have multiple, complex physical and mental health needs. On Monday, December 15, 2014, the Kaiser Family Foundation hosted a…

Proposed Medicaid Expansion in New Hampshire

This fact sheet provides a summary of the waiver request in New Hampshire. New Hampshire has already implemented the ACA Medicaid expansion, but state legislation required the state to submit a waiver to implement mandatory Qualified Health Plan (QHP) premium assistance beginning in January 2016.

Dec. 11 Web Briefing: The Medicaid Managed Care Market Tracker

More than half of the nation’s 67.9 million Medicaid beneficiaries now receive their health care in comprehensive managed care organizations (MCOs) – and the number and share are growing. As states expand their use of Medicaid managed care, the Kaiser Family Foundation has launched a new interactive tool to enhance…

El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!

En Español El seguro de salud, explicado: ¡los YouToons lo tienen cubierto! desglosa conceptos de seguros como primas, deducibles y redes de proveedores.  Explica cómo las personas pagan por su cobertura y cómo obtener cuidado médico y medicamentos recetados con distintos tipos de seguros de salud, incluyendo HMOs y PPOs.…

What Drives Spending and Utilization on Medicaid Drug Benefits in States?

With the approval of new specialty drugs, such as the Hepatitis C treatments Sovaldi and Harvoni, states are mindful that the cost the Medicaid prescription drug benefit could increase. To achieve savings, and improve management and health outcomes, it is important to understand which drugs are most frequently prescribed and which drive spending. Using state drug utilization data provided through the Medicaid Drug Rebate Program, as well as an industry drug database, this issue brief examines trends in prescriptions and spending before rebates, and places findings in the context of policy discussion.

The State Innovation Models (SIM) Program: An Overview

This fact sheet provides an overview of the Center for Medicare and Medicaid Innovation (Innovation Center)’s State Innovation Models (SIM) initiative. It focuses on the delivery system and payment approaches that Model Testing states are taking and discusses what SIM means for Medicaid. Six states – Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont — received Model Testing awards to implement and test their Innovation Plans over 42 months.