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States Should Reevaluate Harmful Medicaid Waivers to Respond to COVID-19
To respond to the COVID-19 crisis, many states have made significant, temporary changes to their Medicaid programs, mostly through emergency waivers and state plan amendments. However, states also have the option to make more lasting changes by reversing harmful policies in their Section 1115 waivers. Unwinding bad waivers not only makes it easier for states,…
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House HEROES Act Bill Would Provide Significant Further Support for State Medicaid Programs
As I have previously written, while helpful, the temporary 6.2 percentage point increase in the federal Medicaid matching rate (FMAP) provided by the Families First COVID-19 response legislation (P.L. 116-127) is clearly insufficient to address the sharply higher state Medicaid costs and overall budget deficits states will experience in this health and economic crisis. That…
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Waive, Suspend, Delay, Eliminate, Forgive CHIP Premiums? Semantics Matter for Families who Need Fiscal Relief from COVID-19 Impacts
As families lose their jobs and employer-sponsored health insurance, eliminating Children’s Health Insurance Program (CHIP) premiums is a great way to provide continuity of coverage for children and fiscal relief for families. But there may be a catch. While some states are submitting state plan amendments to waive collection of premiums or temporarily halt disenrollments…
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Expanding Medicaid Would Help Keep Rural Hospitals Open in 14 Non-Expansion States
I’ve written before about how America’s rural hospitals are in crisis – and the 14 states that still are refusing to expand Medicaid are contributing to financial woes of these institutions. The coronavirus pandemic has pushed these rural providers to the brink. There is stress throughout the health system with even major hospitals in urban…
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Medicaid Managed Care in the Time of COVID-19 and State Budget Cuts
Three months into the pandemic, Medicaid’s role as the nation’s frontline health insurer has come into sharp relief. The focus is on the struggles of frontline hospitals, nursing homes, and health care workers; the vertiginous climb in the number of unemployed and uninsured; the threat to the solvency of pediatric and other primary care providers;…
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State Budget Cuts to Medicaid Means Reduced Federal Funding, Larger Total Cuts
A recent Politico article indicates that states are beginning to consider cuts to their Medicaid program as they face severe budget deficits resulting from the COVID-19 related economic crisis. The Families First Coronavirus Response Act bars states from cutting Medicaid eligibility, making it harder to enroll and disenrolling beneficiaries for the duration of the public…
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New Urban Institute State-Level Health Coverage Estimates as Unemployment Rises
A new Robert Wood Johnson Foundation study conducted by the Urban Institute estimates the impact of increases in the unemployment rate on health coverage among the non-elderly nationally — including changes in Medicaid/CHIP enrollment and the number of uninsured — and on a state-specific basis. A variety of scenarios are assessed. There are three unemployment…
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Critical Need for Further, Large FMAP Increases to Sustain State Medicaid Programs During Economic Crisis
As part of the Families First COVID-19 legislation, Congress provided a temporary 6.2 percentage point increase in the federal Medicaid matching rate (FMAP) for the duration of the public health emergency. The bipartisan National Governors Association and the National Association of Medicaid Directors are both urging Congress to provide further FMAP increases (totaling at least…
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Governors and Medicaid Directors Continue to Press for Withdrawal of Damaging Medicaid Fiscal Accountability Rule
As I have previously written, a significant share of the inadequate fiscal relief that Congress has already provided to states facing huge budget shortfalls could be canceled out if the Trump Administration goes ahead and finalizes its highly damaging “Medicaid Fiscal Accountability” rule (known as MFAR). The rule would adversely affect how states finance their…
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Bipartisan Group of Medicaid Directors, AMA, MACPAC and Stakeholders Issue Urgent Pleas for More Medicaid Help for Safety Net Providers
Those of us who have worked on Medicaid for years have a running joke about Medicaid being the missing “M” in the acronym CMS – which stands for the federal Center for Medicare & Medicaid Services. Medicare has always been the big dog on the block – both in terms of political clout, size and…
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States Can Prevent Surprise Bills for Patients Seeking Coronavirus Care
The ongoing COVID-19 pandemic raises the stakes in the debate over surprise medical bills. Consumers’ fear of incurring medical bills could lead some to avoid testing or treatment. While new federal laws require insurers to waive cost-sharing for COVID-19 testing and the associated medical visit, that protection does not extend to treatment. Nor does it prevent balance…
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The Provider Relief Fund: How Well Does it Protect Patients from Surprise Medical Bills for COVID-19 Related Services?
The cost of health care is a critical concern during the current pandemic. People who worry about out-of-pocket costs are more reluctant to seek care. For those with private health insurance, out-of-pocket costs may take the form of deductibles, copayments, or coinsurance. When receiving services from an out-of-network provider, patients may also face balance bills (amounts billed…
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The Paycheck Protection Program and Healthcare Enhancement Act Fails to Fund the Nation’s Frontline Health Insurer
Today, the Paycheck Protection Program and Health Care Enhancement Act became law.This is the fourth piece of legislation addressing the COVID-19 pandemic and the nation’s economic downturn. It provides additional funding for programs created by the CARES Act, (P.L. 116- 123), including another $380 billion to support small businesses and another $75 billion to help…
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CMS Releases Telehealth Toolkit with Special Emphasis on Pediatrics
The COVID-19 pandemic has significantly disrupted access to health care as providers scramble to up their game in regard to telehealth. To assist states and stakeholders in advancing the use of telehealth, CMS has released a Medicaid and CHIP Telehealth Toolkit with a special emphasis on pediatrics. The toolkit is intended to help identify state-level…
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COVID-19 Medicaid Waiver Soup Explained
Over the past month there has been an explosion of Medicaid waiver activity relating to the COVID-19 pandemic. This activity is not to be confused with the implosion of the Medicaid section 1115 work requirements waivers, which would undermine coverage. Instead, the COVID-related waivers are designed to help state Medicaid programs respond to the pandemic,…
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Getting MAGI Right: Do COVID-19 Stimulus Payments and Extra Unemployment Count toward Medicaid Eligibility?
The most popular blogs I’ve ever written were part of a 2015 series about Getting MAGI right. At the time, MAGI was a little understood acronym for Modified Adjusted Gross Income, which changed the way income and household size is counted for Medicaid and CHIP eligibility for children, pregnant women, parents and expansion adults. As…
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Uninsured and Unemployed? Medicaid and CHIP Provide Lifelines to Families in Need
In these tough times, when so many people have lost their jobs and and their health insurance, Medicaid and the Children’s Health Insurance Program (CHIP) are lifelines families can turn to for help covering the cost of health care. Medicaid and CHIP provide free or low-cost health coverage for children and pregnant women with low…
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Now is the Time to Remove CHIP Waiting Periods and Welcome Kids into Coverage
While maintenance of effort (MOE) provisions in the Families First Coronavirus Response Act and long-standing MOE requirements for children prevent states from implementing any new eligibility or enrollment barriers, states should also be taking steps to remove existing barriers to coverage, including CHIP waiting periods. Before the Affordable Care Act’s (ACA) coverage expansions were implemented…
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March Research Round Up: What We’re Reading
This blog was originally posted on the Georgetown Center on Health Insurance Reforms’ CHIRBlog. This March, we had to reconcile the anniversary of a landmark health law with the anxiety and grief caused by the growing novel coronavirus (COVID-19) pandemic. As we celebrate the 10th year of the Affordable Care Act (ACA), we also look to researchers to help…
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COVID-19 Response: States That Run Their Own ACA Marketplace Are Better Positioned to Help Consumers Get Covered
This blog was originally posted on the Georgetown Center on Health Insurance Reforms’ CHIRBlog. As COVID-19 cases climb, social distancing – the best tool we have to bring the virus to heel – has wrought an unprecedented loss of jobs, income, and health coverage. Over the coming months, the uninsured rate is expected to skyrocket. In the…
