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  • Medicaid Managed Care: Congress Falls Short on Medical Loss Ratios

    Andy Schneider

    On March 9, the President signed into law the Consolidated Appropriations Act, 2024 (P.L. 118-122). Buried in the 428-page text is a 3-line provision delightfully, if somewhat obscurely, titled “Promoting Value in Medicaid Managed Care.” This is a classic in the genre of offsets, flying well under the radar to carry out its mission of…

  • Medicaid and CHIP Provisions in Biden Administration’s Fiscal Year 2025 Budget

    Edwin Park

    On March 11, the Biden Administration issued its budget plan for fiscal year 2025. Based on budget documents from the Office of Management and Budget (OMB) and the Department of Health and Human Services (HHS), here’s a brief summary of the budget’s major provisions related to Medicaid and the Children’s Health Insurance Program (CHIP), along…

  • New from CCF: State Shares of Medicaid/CHIP MAGI Applications Exceeding 45-Day Processing Standard

    Hannah Green

    Federal regulations establish a 45-day standard for acting on Medicaid applications for low-income children, families, and adults (also known as MAGI groups). Applications for MAGI groups are considered untimely and out of compliance with federal rules if processed after the 45-day standard. Just this week, CCF posted new maps that show month-by-month data reflecting the…

  • Surveys Show Unwinding Awareness Lags, Highlighting Need for Outreach

    Hannah Green

    If you know Medicaid, you know that everything is not fine right now. The unwinding of the pandemic continuous coverage provision continues to have major effects on enrollment, with the net decline in child enrollment now exceeding 4 million. Administrative data from across the country show that 73.2% of people who are losing coverage are…

  • Marketplace Enrollment Among Those Losing Medicaid Coverage During Unwinding More than Doubled in November with Start of Open Enrollment Period

    Edwin Park

    As readers of Say Ahhh! know, I have been tracking monthly data (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 selected a marketplace…

  • Survey Looks at Medicaid Unwinding Experiences for Spanish Speakers

    Guest

    By Melody Emenyonu, CCF communications intern, and Kelly Whitener The Protecting Immigrant Families recently partnered with UnidosUS and Noticias Para Inmigrantes to conduct a survey focused on Spanish-speaking adults and their experiences with Medicaid unwinding and the re-enrollment process. All 2,125 participants of the survey had at least one member of their family enrolled in…

  • New CMS Toolkit Outlines Vaccine Coverage and Payment Policies in Medicaid, CHIP and BHP

    Kelly Whitener

    While it has long been clear that vaccines play a critical role in protecting individuals and communities from infectious disease, recent data show declining vaccination rates among individuals of all ages. For the 2020-21 school year, the vaccination rate among kindergartners declined nationwide, despite vaccine exemption policies remaining largely unchanged. Preliminary data indicate that among…

  • Medicaid Managed Care Financial Transparency: Which States Are High Performers?

    Andy Schneider

    As Say Ahhh! readers know, CCF researchers have scanned state Medicaid agency websites for information about the performance of individual managed care organizations (MCOs) for children, for children and youth in foster care, and, most recently, for pregnant and post-partum women. In most of the states we looked, it wasn’t possible to identify which MCOs…

  • State of Florida Files Legal Challenge to Weaken Continuous Coverage Protection for Children in CHIP Nationwide

    Joan Alker

    On February 1, the State of Florida filed a lawsuit in federal court in Tampa against the Centers for Medicare & Medicaid Services in an effort to prevent the agency from enforcing 12-month continuous eligibility in the state’s CHIP program. As loyal readers of Say Ahhh! know, the Consolidated Appropriations Act of 2023 required that…

  • Webinar: State Medicaid Opportunities to Support Mental Health of Mothers and Babies During the 12-Month Postpartum Period

    CCFadmin

    Forty-six states and the District of Columbia have either implemented or plan to implement the state option to extend Medicaid coverage to all enrolled pregnant people from 60 days to 12 months following a pregnancy. In January, Georgetown CCF released State Opportunities to Support Mental Health of Mothers and Babies During the 12-Month Postpartum Period,…

  • CMS Releases Updated Medicaid & CHIP Telehealth Toolkit, Includes State Best Practices and Behavioral Health Strategies

    Anne Dwyer

    This month, CMS released an updated State Medicaid and CHIP Telehealth Toolkit consolidating information from previous toolkits and providing additional guidance – as required by the Bipartisan Safer Communities Act – on issues from billing best practices to strategies for using telehealth in schools. In addition to FAQs on issues such as benefit flexibility, financing,…

  • If You Love Children, You Should Love these Medicaid/CHIP Policy Changes in 2024

    Hannah Green

    Before the new year slips from memory, I wanted to take stock of a few good things happening for kids covered by Medicaid and CHIP this year. Amidst all the dismal news about how nearly 4 million children have lost their coverage during the unwinding – many remain eligible but lost coverage due to red…

  • Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q4 2023

    Ella Mathews

    Q4 2023 was also the third quarter of the PHE “unwinding”—the redetermination of eligibility for all 86.7 million Medicaid enrollees following the expiration of the Public Health Emergency continuous coverage provision in March 2023. These redeterminations have resulted in the disenrollment of over 16 million Medicaid enrollees as of January 2024, which translates into a…

  • A Lifeline for Families of Children With Special Health Care Needs

    Guest

    By Gabby Benitez, Kristen Golden Testa and Nick Lutton Nine months after the start of a national effort to renew Americans’ Medicaid coverage, a tidal wave of people, including almost 200,000 children in California from June through October last year, lost their coverage – and an untold number may be joining them. Most disturbingly, this…

  • Marketplace Enrollment Surges Among Those Losing Medicaid Coverage During Unwinding

    Edwin Park

    As readers of Say Ahhh! know, I have been tracking monthly data (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 selected a marketplace plan. …

  • Medicaid Expansion in Georgia would Improve Maternal and Infant Health Outcomes

    Hannah Green

     One in ten Georgians report knowing someone who has died through pregnancy-related causes. An estimated 57% of Georgians have experienced or know someone who has experienced maternal morbidity. Over 70% of Georgians believe that prioritizing improvements in access to health insurance coverage would help to reduce maternal mortality. These statistics were shared at the…

  • Where do Things Stand with Medicaid Unwinding at the Halfway Point?

    Joan Alker

    KFF’s new research finds that states have reported outcomes for about half of Medicaid renewals nationwide, and so far 16.2 million people have been disenrolled. Meanwhile, our CCF tracker (which accounts for movement on and off the program as well as new enrollment by looking at net enrollment change in each state) shows a 9.37…

  • Minnesota Medicaid Revisits the Question: Managed Care or Fee-for-Service?

    Andy Schneider

    In the beginning, there was fee-for-service (FFS). In this case, the beginning was 1965, when Medicaid (and Medicare) were enacted. FFS was the way that these public programs, as well as almost all private insurers, purchased health care. Fast forward to today. Propelled by an interest in budget predictability and federal policy changes giving them…

  • Press Statement on Florida 12 Month Continuous Coverage for Children Lawsuit

    Joan Alker

    Following is a statement by Joan Alker, executive director of the Georgetown University Center for Children and Families responding to a Florida lawsuit against a federal law requiring 12 months of continuous coverage for children enrolled in Medicaid or CHIP: “As a consequence of the Consolidated Appropriations Act of 2023, a new federal law went…