Medicaid’s Future

Michigan and Indiana, led by Republican governors, each obtained a waiver from the Obama Administration to expand Medicaid in ways that differ from the terms of the Affordable Care Act. Notably, both states’ expansions include provisions related to charging enrollees premiums, requiring them to contribute to health accounts and providing…

Under the Trump Administration, some Republican governors may look to move their Medicaid programs in a more conservative direction. In his latest column for Axios, Drew Altman discusses the arguments about Medicaid “work requirements” and why few people are likely to be affected by them in practice.

This report provides Medicaid highlights from governors’ proposed budgets for state fiscal year (FY) 2018, which runs from July 1, 2017 through June 30, 2018 in most states. Proposed budgets reflect the priorities of the governor and are often blueprints for the legislature to consider.

Medicaid enrollment increased since the start of the pandemic, primarily due to the continuous enrollment provision. KFF estimates that between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision. The Medicaid continuous enrollment provision stopped “churn” among Medicaid enrollees. States approaches…

The unwinding of the continuous enrollment provision will play out differently across the states based on policy choices states have made and variation in their administrative infrastructures. Some states have adopted multiple policies that are more likely to promote continued coverage among those who remain eligible.

The Trump Administration aimed to reshape the Medicaid program by newly approving Section 1115 demonstration waivers that imposed work and reporting requirements as a condition of Medicaid eligibility. However, courts struck down many of these approvals and the Supreme Court recently dismissed pending challenges in these cases. Available implementation data suggests that work requirements were confusing to enrollees and result in substantial coverage loss, including among eligible individuals.

The Impact of the “Medigrant” Plan on the Federal Payments to States The analysis examines the conference agreement plan for the redistribution of federal funds under a block grant for the Medicaid program. It also discusses the implications of the reductions in federal spending for beneficiary coverage. Report: The Impact…

The 23rd annual survey of state Medicaid directors finds that states expect national Medicaid enrollment will decline by 8.6% in state fiscal year (FY) 2024 as state Medicaid agencies continue to unwind pandemic-related continuous enrollment protections. After reaching record high enrollment, these estimates reflect a dramatic year-over-year decline in program…

This report highlights certain policies in place in state Medicaid programs in FY 2023 and policy changes implemented or planned for FY 2024, which began on July 1, 2023 for most states.

With Medicaid about to be a focal point of debate in the Senate, Drew Altman’s Axios column looks at why the idea that the program is broken is more urban legend than fact.