Financing

This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 22nd annual budget survey of Medicaid officials conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report highlights policies in place in state Medicaid programs in FY 2022 as well as policy changes implemented or planned for FY 2022.

We review several policy options to constrain health care spending, primarily by putting downward pressure on provider prices, including price regulation, global budgets, and spending growth targets.

In February 2022, the Kaiser Family Foundation (KFF) and Health Management Associates (HMA) fielded a rapid, mini-survey of Medicaid directors in all 50 states and the District of Columbia as a follow-up to the annual Medicaid Budget Survey conducted in summer 2021. This brief explores Medicaid enrollment and spending growth estimates for FY 2022 and projections for FY 2023, as reported by state Medicaid directors.

Unlike previous recessions in modern history, this past recession was spurred by the spread of a virus (COVID-19), which created a public health crisis with unique health implications. This brief describes the broader impacts of this most recent recession – which lasted from February 2020 to April 2020 — and also explores how trends in Medicaid spending and enrollment differed from past recessions and what that might mean for state Medicaid programs moving forward.

The U.S territories have faced an array of longstanding fiscal and health challenges that were exacerbated by recent natural disasters and the COVID-19 pandemic. This policy watch examines how Medicaid funding for the territories works, the current allotments, and how the Build Back Better Act (BBA) would change Medicaid funding for the territories going forward. While a version of BBBA has passed the house, its fate in the Senate remains uncertain.

As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.

In 2020, donor government funding for family planning activities totaled US$1.40 billion, a decline of more than US$100 million compared to the 2019 amount (US$1.52 billion).

A summary of 10 of the major health coverage and financing provisions of the current Build Back Better Act, with discussion of the potential implications for people and the federal budget.

The Build Back Better (BBB) Act proposes reducing disproportionate share hospital (DSH) allotments by 12.5% starting in federal fiscal year (FFY) 2023 and places limits on Medicaid uncompensated care (UCC) pools for non-expansion states. This policy watch explains what these payments are, what changes have been tied to the ACA, and examines potential implications of changes included in the BBB.

This primer provides an overview of congressional engagement in global health. It examines the structure of Congress and its role and key activities in global health. It then illustrates these by examining two global health examples: the creation and evolution of PEPFAR and the 2014/2015 Ebola outbreak in West Africa.