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A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond
Executive Summary In early 2023, states began final preparations for the end of the pandemic-related Medicaid continuous enrollment provision following passage of the Consolidated Appropriations Act (CAA) of 2023, which lifted the requirement effective March 31, 2023. During the three-year pause on Medicaid disenrollments, Medicaid and CHIP enrollment grew by 32% from 71.3 million to…
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Project 2025 Blueprint Also Includes Draconian Cuts to Medicaid
Last year, conservative organizations led by the Heritage Foundation unveiled a “Project 2025” policy agenda for a potential second term of the Trump Administration. While the overall Project 2025 plan has received growing media attention in recent weeks, its proposals to radically restructure and deeply cut Medicaid have largely flown under the radar. While lacking…
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New Report Explores How States Are Using Section 1115 Demonstration Projects to Address the Health-Related Social Needs of Pregnant and Postpartum Women and Young Children
Over the past few years, states have increasingly sought to use Medicaid to cover services and supports that address unmet individual-level social conditions, known as health-related social needs (HRSN), that can adversely affect health outcomes. Pregnant and postpartum individuals and young children – populations that have significant need for consistent access to healthcare and are…
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For-Profit MCOs in Minnesota Medicaid: No More Welcome Mat
Like 41 other states, Minnesota requires most of those enrolled in its Medicaid program to receive services through managed care organizations (MCOs). Unlike most other states, however, Minnesota is in the midst of a policy conversation about whether to move away from managed care toward fee-for-service. In May 2023, the state legislature directed the Medicaid…
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State Use of Section 1115 Demonstrations to Support the Health-Related Social Needs of Pregnant and Postpartum Women, Infants, and Young Children
By: Allexa Gardner, Tanesha Mondestin, Nancy Kaneb, and Juliana St Goar Download the PDF Executive Summary In an effort to better address the maternal and infant health crisis, states are increasingly seeking to use Medicaid to cover health-related social needs (HRSN) services and supports for pregnant and postpartum individuals and their children, particularly through Medicaid…
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The unlikely new defenders of (at least part of) the Affordable Care Act? Opponents of Medicaid Expansion!
There are many good reasons Republicans formerly opposed to Medicaid expansion have changed their minds and worked toward bipartisan solutions to extend health care. My colleague Jade Little and I detailed this in North Carolina where a bipartisan bill expanding Medicaid overwhelmingly passed last year with support from political pragmatists of both parties, citing the…
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Maternal Mortality Rates Decreased in 2022, but Disparities Persist
Last month, the Centers for Disease Control and Prevention (CDC) released new data indicating that national maternal mortality rates (MMR) fell significantly in 2022. Compared to 2021, the number of maternal deaths fell from 1,205 to 817 overall and the rate fell from 32.9 to 22.3 deaths per 100,000 live births. These new data suggest…
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Social Media: A Critical Tool for States to Leverage as Unwinding Winds Down
It is no secret that social media is one of the most powerful tools state Medicaid and CHIP agencies can employ when attempting to reach out to eligible individuals. Over 70% of adults ages 18–64 use at least one social media site, and targeted outreach on these platforms could help spread the word about programs…
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Marketplace Enrollment Among Those Losing Medicaid Coverage During Unwinding at Lowest Rate Since September 2023
As readers of Say Ahhh! know, I have been tracking monthly data (here, here, here, here, here, here, here, here, here and here) from the Centers for Medicare and Medicaid Services (CMS) on the number of people who were either previously enrolled in Medicaid or had experienced a denial or termination during unwinding who then…
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HHS Selects 10 States to Participate in Medicaid Behavioral Health Clinic Demonstration
Today, the U.S. Department of Health and Human Services (HHS) announced 10 new states have been selected to participate in the Certified Community Behavioral Health Clinic Medicaid Demonstration – Alabama, Illinois, Indiana, Iowa, Kansas, Maine, New Hampshire, New Mexico, Rhode Island and Vermont. The Certified Community Behavioral Health Clinic (CCBHC) Medicaid Demonstration was created in…
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DACA Grantees Can Now Access Marketplace Coverage
The U.S. Department of Health and Human Services (HHS) recently finalized a rule that will allow Deferred Action for Childhood Arrivals (DACA) grantees to access Marketplace coverage starting in November. Under the new rules, DACA grantees will be able to purchase qualified health plans (QHPs) in the Marketplaces and receive financial help in the form…
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How Families’ Medicaid Unwinding Experience Can Help Us Advance Health Equity
By: Kristen Golden Testa, Policy Director at The Children’s Partnership In California, more than half of children get health coverage through Medi-Cal, the state’s Medicaid program. Medi-Cal is a critical support system for California families with low incomes, providing children access to the care they need for a healthy start in life. As nearly 75%…
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Introduction to Medicaid and CHIP Outreach Snapshot Blog Series
We recently released our snapshot of state Medicaid and CHIP outreach activities, just as a number of states are in the final stages of the unwinding and getting people reconnected to coverage becomes more important than ever. While the report provides in-depth analysis into state-provided outreach resources and enrollment assistance, we are also writing a…
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Judge Dismisses Florida’s Attempt to Take Down New Federal Coverage Protection for Children
A federal court in Tampa dismissed the state of Florida’s legal challenge to the Biden Administration’s implementation of a new provision of federal law guaranteeing 12 months of continuous coverage in the Children’s Health Insurance Program – denying the state’s request for a preliminary injunction and, more importantly, dismissed the case from his courtroom. The…
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Strengthened Tool to Address Health-Related Social Needs: The New Medicaid Managed Care Regulation’s “In Lieu of Services” Explained
Medicaid managed care plans have long covered “In Lieu of Services” (ILOS), which are services that are provided in substitution of traditional Medicaid state plan services. For example, a managed care plan might provide a community-based depression screening in lieu of an office visit screening. In 2016, CMS first defined the contours of ILOS in…
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New Rule Seeks to Improve Transparency of State Medicaid Provider Payment Rates
CMS recently finalized two key regulations: “Ensuring Access to Medicaid Services” (Access Rule) and “Medicaid, CHIP Managed Care Access, Finance, and Quality” (Managed Care Rule), aimed at improving access to care in Medicaid across delivery systems (fee-for-service and managed care) and authorities (state plan and waiver services). The rules are long and complex; we’ve summarized…
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Delaware and Tennessee Become First States to Cover Diapers for Young Children in Medicaid through Section 1115 Demonstrations
Last week, CMS announced the approval of section 1115 demonstration project requests from Delaware and Tennessee to provide diapers to young children covered by Medicaid. These approvals mark the first time a state has been authorized to cover diapers for infants in Medicaid regardless of medical necessity due to incontinence issues. Under federal statute, section…
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Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q1 2024
It’s now been four corporate reporting quarters since the start of the PHE unwinding on April 1, 2023. During that time, net national Medicaid enrollment—the combination of disenrollments from redeterminations, re-enrollment by some of those terminated, and new enrollments—has fallen by 13.1 million, including 5.0 million children. Of the disenrollments, 70 percent have been for…
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New Brief Unpacks Medicaid and CHIP Mental Health and Substance Use Disorder Provisions in 2024 Government Funding Package
May is Mental Health Awareness Month. And with Medicaid (alongside the Children’s Health Insurance Program) serving as the largest payer of behavioral health services and covering more than half of all children in the US, you can’t talk about mental health without also talking about Medicaid and CHIP. In March 2024, President Biden signed into…
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Consolidated Appropriations Act, 2024: Medicaid and CHIP Mental Health and Substance Use Disorder Provisions Explained
Download the Full Report Here On March 9, 2024, President Biden signed into law the Consolidated Appropriations Act, 2024 (P.L. 118-42). The Consolidated Appropriations Act, 2024 (CAA 2024) includes a number of Medicaid and Children’s Health Insurance Program (CHIP) provisions related to mental health and substance use disorder (SUD) care and coverage including provisions extending…
