Blog
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Medicaid Managed Care in 2021: The Year that Was
The Medicaid managed care ecosystem is huge and complex. (If you need a primer, the health policy podcast Tradeoffs has a short and entertaining one). As of March of this year, forty states and the District of Columbia were contracting with over 280 different managed care organizations (MCOs). The federal government and states combined spend…
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Research Update: More than 1 in 3 Children Lacked Access to Adequate Coverage in 2019
Regular readers know that, since record lows in 2016, child uninsurance has been climbing in recent years. Regular readers also know that uninsured rates don’t give a full picture of children’s coverage. Similar to our recent paper on kids who experience coverage gaps, a new article in Pediatrics shows that just having some health insurance…
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More from CMS on Postpartum Coverage: FAQs and New State Data
It seems that every week brings a new development in the movement to extend postpartum coverage for 12 months, and this week was no different. On Wednesday, CMS added a “frequently asked questions” section to the extended postpartum coverage option guidance issued on December 7 (see page 14). The agency also released state-specific data on…
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Georgia’s 1332 Waiver Proposal Puts Children and Families at Risk of Losing Coverage
In 2020, Georgia submitted a waiver under Section 1332 of the Affordable Care Act (ACA) to allow the state to exit HealthCare.gov; the Trump Administration approved the request in November of last year. Under this proposal, the 500,000 Georgians who use the federal marketplace every year to enroll in private health plans and Medicaid would…
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Is the Biden Administration Planning to Help Struggling Families by Fixing the Family Glitch?
Close followers of administrative activity may have noticed that the Treasury Department is aiming to issue a notice of proposed rulemaking (NPRM) on the eligibility rules for advanced premium tax credits (APTCs) in the Marketplace. Though no deadline is specified – and the regulatory agenda is often overly ambitious – this could mean that the…
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Oregon’s 1115 Medicaid Waiver Request is a Mixed Bag
State seeks to become the first to provide continuous coverage to all children enrolled in Medicaid until age six while continuing to restrict children’s access to health care by continuing to deny them the EPSDT benefit package provided to children in all other states. After months of engaging stakeholders, Oregon has posted its draft…
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Lessons Learned from Early State Experiences Using Medicaid to Expand Access to Doula Care
The United States is currently experiencing a maternal health crisis, but it’s pregnant people of color who experience its worst effects: Black women, American Indian, and Alaska Native women are up to three times more likely to die from pregnancy-related causes than White women and are also more likely to experience severe complications from pregnancy…
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Removing Barriers to Vaccines for Kids Should be Top Priority
As the COVID-19 vaccine has been approved for adults, then teens and school-aged children, researchers are monitoring the vaccination trends for different groups. About a year after vaccines were approved for adults, almost 72% of the US adult population is fully vaccinated according to the most recent CDC data. Vaccines for teens ages 12 and…
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States Await Federal Action, Use Creative Ways to Fill Gaps in Health Coverage
Momentum is building in state capitals to expand access to health coverage for people left out by the current system, including people excluded from federal coverage options due to immigration status and Marketplace affordability rules known as the family glitch. But before getting into plans for 2022, let’s recap progress made in 2021. As my…
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Surgeon General Issues Advisory on Youth Mental Health Crisis, Highlights Importance of Medicaid and CHIP Coverage and Calls for More Action
This week, the U.S. Surgeon General Dr. Vivek Murthy issued an Advisory highlighting the urgent need to address the nation’s youth mental health crisis. As discussed here on Say Ahhh!, the pandemic has taken an unprecedented toll on the mental health and wellbeing of children, exacerbating long standing gaps in mental health care for children…
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CMS Issues Guidance on New Postpartum Coverage State Option in Medicaid and CHIP
Today CMS released highly anticipated guidance to states implementing the new Medicaid and CHIP state plan option to provide 12 months of extended postpartum coverage to pregnant individuals enrolled in Medicaid beginning April 1, 2022. Created by the American Rescue Plan Act passed earlier this year, this policy option has been widely embraced by states…
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A Few Key Data Points Are Essential in Monitoring Medicaid Enrollment When the Continuous Enrollment Requirement is Lifted
The lifting of the continuous enrollment requirement associated with the COVID-19 public health emergency (PHE) is inevitable, whether it be after the PHE ends or on April 1, 2022 as proposed in the Build Back Better (BBB) Act passed by the House. Regardless of what happens, millions of enrollees are likely to be disenrolled from…
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CMS Tools Suggest Key Roles for Managed Care Plans in Helping Enrollees Retain Coverage
While we were all unwinding from our Thanksgiving celebrations, CMS was busy putting out two new tools to assist state Medicaid eligibility and enrollment operations. The first is focused on preparing for the return to normal operations after the COVID-related continuous enrollment requirement is lifted while the second is a refresher on best practices and…
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A Tale of Two Medicaid Expansions: Missouri v. Oklahoma
In fishing, what one does with the rod after casting the line and hook into the water is as important to success as getting the lure in the right spot of the stream. Following through with enough wiggle and bounce to make that lure look alive is crucial to actually landing a fish for dinner.…
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Recent Resources from Healthy Schools Campaign Illuminate That There is Still Much To-Do to Advance Medicaid Reimbursement in Schools
Pop quiz: How many schools have a full-time nurse on staff? If you guessed anything above 40%, you would unfortunately be wrong. Only 39% of schools in the nation employ full-time school nurses. If you think the numbers on school behavioral health professionals would be better, you would unfortunately be wrong again. 8 million students…
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Just One More Week to Comment on DACA!
The Department of Homeland Security (DHS) issued a notice of proposed rulemaking (NPRM) on the Deferred Action for Childhood Arrivals (DACA) policy in September, and comments are due Monday, November 29. In the spirit of Thanksgiving, we applaud DHS for taking the important step of codifying the DACA policy in regulation, but we think there…
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Build Back Better Act Clears Major Hurdle
The Build Back Better budget reconciliation bill, approved by the U.S. House of Representatives today, includes numerous provisions that would dramatically strengthen and expand both public and private health insurance coverage. The Build Back Better Act prioritizes children’s health, takes critical steps to address our nation’s maternal health crisis, helps close the coverage gap for…
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Build Back Better Legislation: What Does It Mean for Children’s Health Coverage and Care?
There has been very little public discussion of the provisions to advance child health in the Build Back Better (BBB) bill. Big ticket items like whether a Medicare dental, hearing, and vision benefit will be added, disputes over drug pricing reforms, and of course, filling the coverage gap in the non-expansion states, have taken up…
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Maternal Health Home Option in Build Back Better Plan Lays Groundwork for Two-Generation Success
Released in late October, the most recent House text of the Build Back Better plan included an exciting late addition: a new Medicaid pathway to incentivize high-quality, team-based care for pregnant and postpartum people. The new state option provides a temporary enhanced match to develop and grow practices to comprehensively anticipate and coordinate care needs,…
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Comment Period for New DACA Regulation Closes November 29
The Department of Homeland Security (DHS) issued a new notice of proposed rulemaking (NPRM), “Deferred Action for Childhood Arrivals,” in late September and the comment deadline of November 29 is fast approaching. The NPRM seeks to codify the DACA policy originally laid out in a memo by then-Secretary of DHS Janet Napolitano in June 2012.…
