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Unwinding Wednesday #11: No 60-day Notice on the Unwinding; PHE Expected to Be Extended Until April 2023
[Editor’s Note: The end-of-year bipartisan funding agreement released on December 20 would delink the continuous coverage requirement from the HHS Secretary’s declaration of a public health emergency and start the Medicaid “unwinding” process on April 1. The agreement includes 12 months of continuous coverage for children and other provisions designed to protect individuals eligible for…
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States Leading the Way on Connecting All Children with Health Coverage – Will Congress Follow?
According to the Urban Institute, over half of the remaining uninsured children are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) but unenrolled. About a third of uninsured children are ineligible for Medicaid or CHIP because their family income exceeds the eligibility thresholds. Another 10% are ineligible for Medicaid/CHIP because of their immigration…
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Transparency in Medicaid Managed Care: The Power of the California Procurement Database
The Illinois Answers Project has just published a must-read piece of investigative reporting: “Insurance Giant Failed Foster Kids with Inadequate Care.” It raises a number of disturbing questions about the way children in foster care are being treated in the state’s Medicaid managed care program. About the performance of a Centene subsidiary that has contracted…
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South Dakota Voters Pass Medicaid Expansion. What Happens Next?
South Dakota voters followed the pattern of six other states and voted this week to expand Medicaid, extending affordable health care to more than 40,000 adults largely working in jobs without health coverage like hospitality, food service, and construction. In taking this action, South Dakota now joins 39 other states and the District of Columbia.…
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Unwinding Wednesday #10: FAQs Provide Additional Clarity on State Options Before and During the Unwinding
Over the past two years, CMS has published a wealth of resources designed to aid states in the unwinding process. These documents, which provide guidance and lay out flexibilities available to states, are available on a single landing page on Medicaid.gov. In our tenth installment of Unwinding Wednesday, we are highlighting a recent addition to…
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Medicaid Managed Care: The Big Five in PHE Q11 (Q3 2022)
September 30 marked the end of the 3rd quarter of this calendar year. It also marked the end of the 11th quarter of the Public Health Emergency (PHE). The two are not unrelated. During the PHE, states receive an additional 6.2 percentage points on their regular federal matching rate if they agree not to terminate…
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Comments on Streamlining Medicaid/CHIP Eligibility Determination, Enrollment and Renewal Processes
Georgetown University Center for Children and Families submitted these comments to CMS on the “Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes Proposed Rule.” EE NPRM CCF Comments
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Comments on Amendments to “KanCare” Medicaid Demonstration
The Georgetown University Center for Children and Families and the Center on Budget and Policy Priorities submitted the following comments to CMS regarding Kansas’ application to amend the “KanCare” Medicaid demonstration that would authorize continuous eligibility for parents and caretaker relatives. KanCare Amendment Comments
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Letter Regarding Healthy Michigan Plan Section 1115 Demonstration Extension Application
The Georgetown University Center for Children and Families and the Center on Budget and Policy Priorities sent this letter to CMS regarding Michigan’s application to extend its “Health Michigan” 1115 waiver. CCF-CBPP_Healthy Michigan Plan Extension Letter
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New MACPAC Data on the Highly Effective Medicaid Drug Rebate Program
As I have previously explained, under the highly effective Medicaid Drug Rebate Program, drug manufacturers must provide substantial rebates to the federal government and states as a condition of having their drugs covered by Medicaid. The rebates apply to both fee-for-service and to managed care. A groundbreaking 2021 Congressional Budget Office study found that compared…
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Unwinding Wednesday #9: CMS Should Add the Unwinding Supplemental Data to the Medicaid Performance Indicators
In last week’s Unwinding Wednesday blog, my colleague Allie Gardner noted that CMS is requiring states to provide supplemental data for monitoring the unwinding of the Medicaid continuous coverage protection. These data are in addition to the performance indicator data that states have been required to submit monthly since 2013. But … the supplemental data…
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Medicaid Beneficiaries Ask the Supreme Court: Do We Have a Friend in You?
On November 8, the Supreme Court will hear oral argument in what my colleague Leo Cuello has called “the most consequential case you’ve never heard of:” Health and Hospital Corporation of Marion County v. Talevski. The case began as a lawsuit against a county-owned nursing facility in Indiana by a now-deceased resident who alleged that…
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The End of Medicaid Rights May Be Upon Us: You Need to Know About the Talevski Case
The Supreme Court, the same court that trashed decades of settled precedent to overturn Roe and, in NFIB, for-the-first-time-ever ruled that a federal spending program (the Medicaid expansion) was “coercive” upon states, that court, is about to decide whether to completely wipe out the rights of Medicaid enrollees. Buckle up, friends. On November 8, the…
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HHS Announces New Planning Grants for Medicaid-Funded Behavioral Health Clinic Demonstration
Last week, the U.S. Department of Health and Human Services announced it will be awarding up to $15 million in new planning grants to states as part of its national expansion of the Medicaid-funded Certified Community Behavioral Health Clinic (CCBHC) demonstration program under the Bipartisan Safer Communities Act. The announcement comes on the heels of…
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Comments on Temporary Increase in FMAP in Response to Covid-19 Public Health Emergency Reopening of Public Comment
Georgetown University Center for Children and Families submitted comments to CMS on the “Medicaid Program; Temporary Increase in Federal Medical Assistance Percentage (FMAP) in Response to the COVID-19 Public Health Emergency (PHE); Reopening of Public Comment Period”. CCF Comments IFR-C MOE 2022
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Unwinding Wednesday #8: Key Data to Monitor Unwinding of the Medicaid Continuous Coverage Protection (Part 2)
As we prepare for the eventual end of the Medicaid continuous coverage protection, a key focus here at CCF has been on monitoring the unwinding process. In last week’s Unwinding Wednesday, my colleague Tricia Brooks highlighted data such as the Medicaid and CHIP performance indicator (PI) data that can be useful in monitoring the unwinding.…
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Gracias a las leyes federales, hay menos niños sin seguro medico en Georgia, pero eso podría cambiar pronto
Georgia ocupa el cuarto lugar entre los estados con el peor número de niños sin seguro médico, con un estimado de 176,000 niños sin cobertura de salud. Comparado con los estados vecinos del sur, Georgia tiene un desempeño insatisfactorio. La tasa de niños sin seguro en todos los estados vecinos—con excepción de la Florida—es mucho…
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The Number of Uninsured Children in Georgia Has Declined Thanks to Federal Law But May Rise Soon
The state of Georgia has the fourth highest number of uninsured children with an estimated 176,000 Georgia children going without health coverage. Georgia performs poorly in comparison to its neighbors in the deep south. All of Georgia’s neighboring states—with the exception of Florida—have better child uninsured rates (see Figure 1). Children without health insurance have…
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Mandatory Reporting on Medicaid Quality Measures: What Did Congress Intend?
In August, CMS posted its proposed rule to codify Congressional action taken in 2018 to mandate state reporting of the Child Core Set and the Adult Behavioral Health Core Set of quality measures in Medicaid and CHIP, starting in 2024. Until 2024, state reporting on the core sets is voluntary. I did a quick scan…
