Medicaid

This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

A new animated video features the YouToons as they get ready for Obamacare and explore health insurance changes under the Affordable Care Act (ACA). The cartoon serves as a health reform tutorial for consumers and organizations.

This report discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states face as they transform the way they do business and achieve key national goals. The paper relies on an extensive review of federal and state administrative responsibilities drawn from statute, regulation, and relevant literature, coupled with discussions with six current Medicaid directors.

This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.

Rising concerns about mental health and substance use disorder have led to new policy initiatives and funding to improve access and quality of services to address mental health crisis. While crisis call centers are accessible nationwide, the availability and characteristics of other components of the crisis continuum–mobile crisis units and stabilization centers–vary across and within states, as does the financing of these systems. The American Rescue Plan Act (ARPA), passed in 2021, had several Medicaid-focused provisions to improve and expand access to crisis systems in Medicaid. Medicaid programs can access the 85% enhanced federal match for ARPA mobile crisis services for eligible Medicaid enrollees. As of November 2023, 13 states obtained CMS approval for state plans amendments to cover ARPA community-based mobile crisis intervention services, making them eligible for enhanced federal matching funds under the American Rescue Plan Act (ARPA) option. Beyond the ARPA incentives, recent Department of Justice (DOJ) investigations into police handling of mental health calls could spur expansion of mobile crisis.

At the beginning of 2024, nine months into states’ efforts to unwind the Medicaid continuous enrollment provision and reverify enrollees’ eligibility, states have completed renewals for less than half of all enrollees. To gain a better understanding of what challenges states are facing and the effects of different unwinding strategies,…

Data are important to help monitor how unwinding is going across states, but trackers and dashboards only tell part of the unwinding story. This brief examines the perspectives of state officials and others involved in the unwinding process. The brief provides information on outreach and engagement, renewal processes and coverage transitions, providing lessons for the ongoing unwinding process, as well as for how to conduct more effective Medicaid renewals generally in the future.

This policy watch examines recent trends in children’s poverty rates and the impact of expiring federal aid, explores recent changes in Medicaid coverage for children, and discusses what to watch as families contend with these compounding changes.

This policy watch explains the Medicaid prescription drug rebate cap, examines how many drugs might be impacted, and explores the implications of recent manufacturer responses for Medicaid programs and enrollees.

This brief discusses state uptake of special waivers aimed to mitigate procedural disenrollments during the unwinding of the continuous enrollment provision.