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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

    Hannah Green

    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…

  • CCF Comments to Medicaid Drug Rebate Program Proposed Rule

    Edwin Park

    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…

  • Proposed Expansion of Self-funding for Small Employers Would Roll Back Affordable Care Act Protections, Pre-empt State Insurance Oversight

    Guest

    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…

  • A Closer Look at the Transparency Provisions of CMS’s Proposed Medicaid Access and Managed Care Rules

    Andy Schneider

    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…

  • Medicaid Managed Care: A New Group Arrives on the CMCS Block

    Andy Schneider

    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…

  • New CBO Estimates of the Impact of Unwinding on Medicaid Enrollment, Uninsured

    Edwin Park

    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…

  • Preventing the “Unwelcome Mat” Effect: Ensuring Eligible Kids Remain Covered

    Allexa Gardner

    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…

  • Medicaid Funding for Home Visiting: Time to Scale What Works for Young Children and Families

    Elisabeth Wright Burak

    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…

  • New CMS Proposed Rule Could Help State Medicaid Programs Negotiate Greater Supplemental Rebates for Certain High-Cost Drugs

    Edwin Park

    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…

  • Maternal Mental Health Month Shines Light on Need for Policy Solutions

    Maggie Clark

    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…

  • More Outreach to Families Needed During the Unwinding; Some States Are Stepping Up Their Game

    Cathy Hope

    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…

  • A Closer Look at the Medical Loss Ratio (MLR) Provisions of CMS’s Proposed Medicaid Managed Care Rule

    Andy Schneider

    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…

  • New Interactive Maps Show Importance of Medicaid Coverage to Children and Families in Rural Counties and Small Towns

    Joan Alker

    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…

  • Research Update: It’s Simple—Medicaid Helps People Work

    Aubrianna Osorio

    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,…

  • It’s Here! An Introduction to the Much-Anticipated Updated School-Based Medicaid Services and Administrative Claiming Guide

    Margaux Johnson-Green

    May is Mental Health Awareness Month, and last week’s news takes this month to heart with the release of the much-awaited Comprehensive Guide to Medicaid Services and Administrative Claiming by the Centers for Medicare & Medicaid Services (CMS) in consultation with the US Department of Education (ED). The first comprehensive update in two decades, CMS’s…

  • Medicaid Managed Care: Results for the Big Five in PHE Q13

    Andy Schneider

    The earnings reports for the “Big Five” for the quarter ending March 31—known here as PHE Q13—are in.  The “Big Five”—CVSHealth (Aetna), Centene, Elevance Health (formerly Anthem), Molina Healthcare, and United Health Group—need no introduction, either to state Medicaid agencies or investors.  Together, they had 44.2 million Medicaid enrollees as of March 31.  If children…

  • How Many Children Just Lost Coverage in Florida?

    Joan Alker

    We just received a copy of Florida’s report to CMS on its first month of “unwinding” the Medicaid continuous coverage provisions for April and the data is alarming. Of the 461,322 people whose eligibility was checked, more than half — 54% or 249,427 people — were terminated. Most of those terminated (82%) had their cases…

  • Arkansas Unwinding Numbers Show What’s at Stake for Very Young Children

    Elisabeth Wright Burak

    Georgetown University Center for Children and Families (CCF) has sounded the alarm bells for more than a year warning that without strong state leadership and careful attention, millions of children, parents, disabled people and others eligible for Medicaid could be erroneously disenrolled for procedural reasons. Children are far more likely to lose Medicaid and CHIP…

  • Update: North Carolina Passed Medicaid Expansion – Here’s How Politicians Justified Change of Heart

    Adam Searing

    In March this year, the North Carolina legislature passed Medicaid expansion with bipartisan support, becoming the first state to pass expansion legislatively since Virginia in 2018. In an interesting turn of events, many House and Senate Republicans in North Carolina, who for years staunchly opposed expanding Medicaid, changed their positions leading up to the bill’s…