Blog
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New CBO Study Explores the Long-Term Fiscal Benefits of Medicaid Coverage in Childhood
There is a large and growing body of research demonstrating the long-term benefits of Medicaid coverage during childhood and during pregnancy. This includes better health and lower incidence of disability in adulthood, higher educational attainment, and greater earnings and intergenerational mobility. Now, in a new working paper, the Congressional Budget Office (CBO) has conducted an…
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Bipartisan Senate Finance Committee Legislation Includes Enhanced Medicaid Pharmacy Pricing Survey Provision
On November 8, 2023, on an unanimous 26-0 vote, the Senate Finance Committee approved the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act. The bill includes a number of Medicare and Medicaid provisions but also incorporates two sound Medicaid drug pricing provisions related to “spread pricing” in Medicaid managed care and to Medicaid pharmacy…
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Can MMRCs Do More to Inform State Medicaid Maternal Health Efforts?
As rates of maternal mortality have risen in the United States, maternal mortality review committees (MMRCs) have been an important tool to understand why these maternal deaths occur. State MMRCs consist of multidisciplinary representatives to review deaths that occur during or within a year of pregnancy. In our recent 12-state scan of Medicaid MCO performance…
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CCF’s Unwinding and Enrollment Trackers Explained
Since Medicaid unwinding of the continuous coverage requirement has begun, net child Medicaid enrollment has fallen by more than two million and overall net Medicaid enrollment has declined by more than five million. We have received some questions about how we calculate these net enrollment figures as well as the basis of other unwinding data…
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Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q3 2023
The “Big Five” Medicaid managed care companies—Centene, CVS Health (Aetna), Elevance Health (formerly Anthem), Molina Healthcare, and UnitedHealth Group—have reported their Medicaid enrollment for the quarter ending September 30. The downward trend that began in Q2 continued for all of the companies except Molina, which experienced a small net increase (+16,000). Centene reported the largest…
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States Cannot Terminate CHIP Coverage for Non-Payment of Premiums Under 12-Months Continuous Eligibility Requirement
The Consolidated Appropriations Act, 2023 established a new requirement that all states provide 12-months continuous eligibility in Medicaid and the Children’s Health Insurance Program (CHIP) for children starting on January 1, 2024. Currently, only about half of the states have taken up the option to provide 12-months continuous eligibility for children in both programs. In…
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New Federal Rules Seek To Strengthen Mental Health Parity
By Maanasa Kona, Assistant Research Professor at the Center on Health Insurance Reforms On July 25, 2023, the Departments of Labor, Health and Human Services, and the Treasury (the tri-agencies) proposed a new rule to strengthen the enforcement of the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and ensure that patients can access mental health and substance…
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Marketplace Enrollment Rises Again in July But Still Represents Only Small Share of Those Losing Medicaid Coverage During Unwinding
As readers of Say Ahhh! know, I have been tracking monthly data (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 who then selected a marketplace plan. CMS has just issued new…
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Updated List of Flexibilities Highlight Variety of Approaches States Are Taking to Promote Continuity of Coverage During the Unwinding
To meet the unprecedented moment of the unwinding of the Medicaid continuous coverage protection, states have implemented a range of innovative policies to make the renewal process smoother for enrollees as well as state eligibility workers. One tool that states have increasingly used is Section 1902(e)(14)(A) waivers, or “e14s,” which we have written about previously…
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Medicaid Enrollment is Down by Five Million Including Two Million Children
We’ve been tracking changes in Medicaid enrollment for everyone including children. Sadly, today our tracker of net child Medicaid enrollment losses went over two million nationwide and exceeded five million for adults and children combined. And states are not done yet! According to KFF’s recent estimates, we’re only about one-third of the way through the…
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What’s New for 2024 Marketplace Enrollment?
By Emma Walsh-Alker, Georgetown University Center on Health Insurance Reforms The annual open enrollment period for Affordable Care Act (ACA) Marketplace coverage kicks off November 1 in most states. A number of new and ongoing policy changes will impact the Marketplace in 2024, including special enrollment opportunities tied to the Medicaid “unwinding,” continuing enhanced financial…
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Eliminating CHIP Premiums Could Help with Child Transitions from Medicaid to CHIP
Last week, Joan Alker and Jade Little blogged about the troubling trend of children losing Medicaid as enrollment declines near 2 million. Leading up to the unwinding, researchers estimated that 57% of children losing Medicaid would be eligible for CHIP based on income. There are many reasons why children don’t successfully transition seamlessly from Medicaid…
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Response to American Academy of Pediatrics New Policy Statement
The following is a statement by Joan Alker, Executive Director of the Center for Children and Families at Georgetown University’s McCourt School of Public Policy in response to American Academy of Pediatrics New Policy Statement: “I applaud the new policy statement by the American Academy of Pediatrics outlining the direction that Medicaid and the Children’s Health Insurance…
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What Does 12-month Continuous Eligibility for Children Mean for CHIP Pregnancy Coverage?
Several weeks ago, I blogged about the federal guidance CMS sent to states on the implementation of 12-month continuous enrollment (CE) for children starting on January 1, 2023, as required by the Consolidated Appropriations Act of 2023 (CAA). In the guidance, CMS provided details on how implementation of 12-month CE impacts the group of individuals…
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Almost 2 Million Fewer Children are Enrolled in Medicaid: Are They Moving to CHIP?
We’ve been tracking net child enrollment losses in Medicaid with state administrative data and our tracker is going to hit two million soon. In reality the number is certainly at two million already given that these numbers don’t include three states (Michigan, New York, and Oregon) and that Texas data, a state which has disenrolled…
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Medicaid Managed Care: Transparency of Performance on Maternal Health
Our nation is in the midst of an ongoing maternal health crisis, one that particularly affects Black women. The causes are complex, the need to address them is urgent, and there is no single solution. One of many potential solutions that has not received enough attention is Medicaid managed care. Medicaid, the nation’s largest health…
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Marketplace Enrollment During Medicaid Unwinding Ticked Up in June but Remained Modest
I have been regularly reporting on monthly data (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 who then selected a marketplace plan. At the end of September, CMS issued new data for…
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CMS Makes the Right Call on Utah’s Medicaid Waiver: Where Do Things Stand on Postpartum Coverage?
In a little-noticed but important action, CMS recently notified the Utah Medicaid agency that it should proceed with extending postpartum coverage from 60 days to 12 months under the state plan amendment (SPA) option rather than continuing to pursue its Section 1115 waiver request. At first blush, this seems like a distinction only the most…
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How Did We Get Here? A Recent Legislative History of Medicaid Managed Care
Just over 25 years ago, Congress enacted a major change in federal policy on Medicaid managed care. It eliminated the 75/25 rule—the requirement that no more than 75 percent of the enrollees in a Medicaid managed care organization (MCO) could be Medicaid or Medicare beneficiaries. The logic of the rule was that if an MCO…
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Black Maternal & Mental Health Summit Highlights the Urgency for Policy and Practice Change
In July, I had the chance to attend the Black Maternal & Mental Health Summit hosted by the Shades of Blue Project. Founder Kay Matthews established Shades of Blue in 2013 after the loss of her stillborn daughter. With worsening maternal morbidity rates in the United States, Kay has turned to advocacy as a way…
