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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
