Say Ahhh!
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Research Update: This Pride Month, We Celebrate Improvements in Coverage and Access for LGBTQ+ Adults
This week I am proud to highlight two recent studies showing that adults identifying as lesbian, gay, bisexual, and transgender (LGBT) have made significant gains in coverage and access to care over the past several years since the Affordable Care Act (ACA) and its Medicaid expansions have taken effect. LGBT adults have historically faced serious…
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House Republican Study Committee Budget Plan Again Includes Draconian Medicaid Cuts
On June 14, 2023, the Republican Study Committee (RSC), whose members comprise more than three-quarters of the House Republican caucus, announced its fiscal year 2024 budget plan. The budget plan proposes to cut total federal Medicaid, CHIP and Affordable Care Act marketplace subsidy spending by more than half over the next decade, relative to current…
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Research Update: What Does Persistent Poverty Mean for Medicaid?
A recent report from the U.S. Census Bureau has identified 341 counties nationwide that are in persistent poverty, which is defined as having a poverty rate of 20% or higher during the past 30 years from 1989 through the 2015-2019 data period (for context, the national poverty rate in 2015-2019 was 13.4%). While persistent poverty…
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Medicaid Unwinding: Why Retroactive Coverage is not the Answer to Procedural Disenrollments as Some Claim
As readers of SayAhhh! know, we are closely monitoring the impact of Medicaid unwinding. We’ve been worried about inappropriate and large coverage losses for children and families for quite some time now – and as states get started and are reporting large numbers of procedural terminations our fears have not been allayed. There are those…
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Unpacking Unwinding Data: What’s with All the Different Numbers?
As of June 1st, most states have started terminating Medicaid coverage for children, low-income families, and others for non-eligibility, procedural reasons. We are trying to get our hands on as much data as we can to get a sense of the outcomes of Medicaid renewals and what the unwinding process looks like across states. Transparency…
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How Are States Addressing Mental Health Needs of Infants and Toddlers in Medicaid Policy? New 50-state Report
As lawmakers scramble to address the nation’s worsening mental health crisis among children, few of these efforts have focused on the unique developmental needs of children before they reach kindergarten. It’s hard to imagine an infant or toddler experiencing mental health challenges, but as ZERO TO THREE shows,10-16% of young children experience mental health conditions,…
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CMS Asks States and Stakeholders to Lean In and Help Respond to Mounting Concerns About Eligible Children, New Moms and Others Losing Medicaid During Unwinding
As outcomes data has emerged from states getting an early start on resuming Medicaid renewals, there are mounting concerns about eligible children, new moms, and others losing coverage due to procedural disenrollments. In response, CMS released additional information on the unwinding, including a letter from HHS Secretary Becerra to governors urging them to adopt additional…
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CCF Comments to Medicaid Drug Rebate Program Proposed Rule
Under the highly effective Medicaid Drug Rebate Program (MDRP), drug manufacturers must provide substantial rebates to state Medicaid programs in order for their prescription drugs to be covered by Medicaid. Because of the MDRP, the Congressional Budget Office has found that Medicaid obtains the lowest prescription drug prices, net of rebates and discounts, among other…
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Proposed Expansion of Self-funding for Small Employers Would Roll Back Affordable Care Act Protections, Pre-empt State Insurance Oversight
By Georgetown University McCourt School of Public Policy Center on Health Insurance Reforms The U.S. House of Representatives Education & Workforce Committee is poised to advance a bill, H.R. 2813, that would encourage the expansion of self-funded employer-based insurance exempt from key Affordable Care Act (ACA) protections and preempt states’ efforts to stabilize premiums for small…
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A Closer Look at the Transparency Provisions of CMS’s Proposed Medicaid Access and Managed Care Rules
Editor’s Note: Since this post was published, CCF submitted formal comments on both the Medicaid Access and Managed Care proposed rules. Transparency has long been underrated as a way of improving access to care in Medicaid. This may be about to change. Two proposed rules that CMS published on May 3 use transparency—making information about…
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Medicaid Managed Care: A New Group Arrives on the CMCS Block
There’s a new box on the Center for Medicaid & CHIP Services (CMCS) organization chart! It’s the Managed Care Group, one of (now) eight Groups within CMCS that manage the Medicaid program for the federal government. You’re probably thinking, “So what? A federal bureaucracy gets a new Group. What difference will that make for children…
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New CBO Estimates of the Impact of Unwinding on Medicaid Enrollment, Uninsured
On May 24, 2023, the Congressional Budget Office issued new health coverage estimates for people under age 65 through a Health Affairs article and an updated May 2023 “Federal Subsidies for Health Insurance Coverage” baseline. The estimates show the expected adverse impact of unwinding of the Medicaid continuous coverage protection in substantially reducing Medicaid enrollment…
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Preventing the “Unwelcome Mat” Effect: Ensuring Eligible Kids Remain Covered
One of our biggest concerns heading into the unwinding has been children experiencing gaps in health care coverage, especially as a result of losing coverage despite remaining eligible. As my colleague Elisabeth Wright Burak detailed a few weeks ago, these fears are already coming true in at least one state. Later this week, most states…
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Medicaid Funding for Home Visiting: Time to Scale What Works for Young Children and Families
As more states adopt Medicaid’s postpartum extension, making health coverage work for postpartum people and their newborns requires dedicated attention by states on the best ways to ensure mom and child get the right care at the right time. One popular, evidence-based intervention for young families is home visiting. The approach typically includes some combination…
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New CMS Proposed Rule Could Help State Medicaid Programs Negotiate Greater Supplemental Rebates for Certain High-Cost Drugs
On May 23, 2023, the Centers for Medicare and Medicaid Services announced a new proposed rule related to the Medicaid Drug Rebate Program (MDRP) and other Medicaid drug pricing, reimbursement and data collection issues. While much of the proposed rule focuses on regulatory changes conforming to legislation affecting the MDRP enacted in recent years as…
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Maternal Mental Health Month Shines Light on Need for Policy Solutions
May is a month for moms: we celebrate Mother’s Day, it’s maternal mental health awareness month, and Congressional leaders chose May to reintroduce the Black Maternal Health Momnibus, a group of a dozen bills designed to address all facets of the Black maternal mortality crisis. Giving birth and taking care of a young child is…
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More Outreach to Families Needed During the Unwinding; Some States Are Stepping Up Their Game
KFF released new survey data that finds two-thirds of Medicaid enrollees are unprepared for the renewal process as states begin the process of “unwinding” the Medicaid continuous coverage requirement that was lifted by Congress on March 31. The KFF survey includes more interesting data that reveals that large majorities across demographic groups are not aware…
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A Closer Look at the Medical Loss Ratio (MLR) Provisions of CMS’s Proposed Medicaid Managed Care Rule
Editor’s Note: Since this post was published, CCF submitted formal comments on the Managed Care proposed rule. Earlier this month, CMS proposed changes to regulations that govern the operation of Medicaid managed care in 41 states. The main purpose of the proposals is to improve access to care (by, among other things, beefing up network adequacy…
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New Interactive Maps Show Importance of Medicaid Coverage to Children and Families in Rural Counties and Small Towns
Georgetown University Center for Children and Families, with data from the University of North Carolina’s Sheps Rural Health Research Center, has examined the role Medicaid plays in health insurance coverage in rural areas, including how state Medicaid expansions helped reduce uninsurance, as part of our rural health policy project launched in 2017. Now we have…
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Research Update: It’s Simple—Medicaid Helps People Work
My colleagues have been analyzing the highly damaging Medicaid work reporting requirement provisions of the House-passed debt ceiling bill crafted by Speaker McCarthy, including how it would likely harm people with disabilities and parents. There is an overwhelming stack of evidence showing that work requirements are a terrible idea: they don’t actually improve employment rates,…
