X

Say Ahhh!

  • A Deeper Dive into Florida’s Lawsuit Seeking to Undermine the New Requirement for 12-Months Continuous Eligibility for Children in Separate State CHIP Programs

    Edwin Park

    As my colleague Joan Alker explains, the state of Florida recently sued the federal government to block guidance from the Centers for Medicare and Medicaid Services (CMS) implementing the new requirement that all states provide 12-months continuous eligibility for children in Medicaid and the Children’s Health Insurance Program (CHIP) as of January 1, 2024.  Specifically,…

  • Medicaid Managed Care Appeals and Grievances:  GAO Takes a Look

    Andy Schneider

    Last week, GAO issued a performance audit of data on Medicaid MCO appeals and grievances. The database GAO examined was the first year of Managed Care Program Annual Reports (MCPARs) submitted by state Medicaid agencies to CMS.  MCPARs are one of three reports on which CMS relies to conduct oversight of state managed care programs…

  • Latest House Republican Study Committee Budget Plan Again Includes Draconian Medicaid Cuts

    Edwin Park

    On March 20, 2024, the Republican Study Committee (RSC), whose members comprise more than three-quarters of the House Republican caucus, announced its fiscal year 2025 budget plan.  The budget plan proposes to cut total federal Medicaid, Children’s Health Insurance Program (CHIP) and Affordable Care Act marketplace subsidy spending by nearly 54 percent over the next…

  • CMS Informational Bulletin Calls Out 10 “Do Nots” in Conducting Renewals

    Hannah Green

    In an Informational Bulletin (CIB) released on March 15, 2024, CMS reminds states of their obligation to comply with all existing federal renewal requirements in Medicaid and CHIP. The CIB is the result of questions CMS has received from states, stakeholders, and external partners regarding the permissibility of certain renewal practices. The CIB describes 10…

  • Medicaid Managed Care: Congress Falls Short on Medical Loss Ratios

    Andy Schneider

    On March 9, the President signed into law the Consolidated Appropriations Act, 2024 (P.L. 118-122). Buried in the 428-page text is a 3-line provision delightfully, if somewhat obscurely, titled “Promoting Value in Medicaid Managed Care.” This is a classic in the genre of offsets, flying well under the radar to carry out its mission of…

  • Medicaid and CHIP Provisions in Biden Administration’s Fiscal Year 2025 Budget

    Edwin Park

    On March 11, the Biden Administration issued its budget plan for fiscal year 2025. Based on budget documents from the Office of Management and Budget (OMB) and the Department of Health and Human Services (HHS), here’s a brief summary of the budget’s major provisions related to Medicaid and the Children’s Health Insurance Program (CHIP), along…

  • New from CCF: State Shares of Medicaid/CHIP MAGI Applications Exceeding 45-Day Processing Standard

    Hannah Green

    Federal regulations establish a 45-day standard for acting on Medicaid applications for low-income children, families, and adults (also known as MAGI groups). Applications for MAGI groups are considered untimely and out of compliance with federal rules if processed after the 45-day standard. Just this week, CCF posted new maps that show month-by-month data reflecting the…

  • Surveys Show Unwinding Awareness Lags, Highlighting Need for Outreach

    Hannah Green

    If you know Medicaid, you know that everything is not fine right now. The unwinding of the pandemic continuous coverage provision continues to have major effects on enrollment, with the net decline in child enrollment now exceeding 4 million. Administrative data from across the country show that 73.2% of people who are losing coverage are…

  • Marketplace Enrollment Among Those Losing Medicaid Coverage During Unwinding More than Doubled in November with Start of Open Enrollment Period

    Edwin Park

    As readers of Say Ahhh! know, I have been tracking monthly data (here, here, here, here, 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 during unwinding who then selected a marketplace…

  • Survey Looks at Medicaid Unwinding Experiences for Spanish Speakers

    Guest

    By Melody Emenyonu, CCF communications intern, and Kelly Whitener The Protecting Immigrant Families recently partnered with UnidosUS and Noticias Para Inmigrantes to conduct a survey focused on Spanish-speaking adults and their experiences with Medicaid unwinding and the re-enrollment process. All 2,125 participants of the survey had at least one member of their family enrolled in…

  • New CMS Toolkit Outlines Vaccine Coverage and Payment Policies in Medicaid, CHIP and BHP

    Kelly Whitener

    While it has long been clear that vaccines play a critical role in protecting individuals and communities from infectious disease, recent data show declining vaccination rates among individuals of all ages. For the 2020-21 school year, the vaccination rate among kindergartners declined nationwide, despite vaccine exemption policies remaining largely unchanged. Preliminary data indicate that among…

  • Medicaid Managed Care Financial Transparency: Which States Are High Performers?

    Andy Schneider

    As Say Ahhh! readers know, CCF researchers have scanned state Medicaid agency websites for information about the performance of individual managed care organizations (MCOs) for children, for children and youth in foster care, and, most recently, for pregnant and post-partum women. In most of the states we looked, it wasn’t possible to identify which MCOs…

  • State of Florida Files Legal Challenge to Weaken Continuous Coverage Protection for Children in CHIP Nationwide

    Joan Alker

    On February 1, the State of Florida filed a lawsuit in federal court in Tampa against the Centers for Medicare & Medicaid Services in an effort to prevent the agency from enforcing 12-month continuous eligibility in the state’s CHIP program. As loyal readers of Say Ahhh! know, the Consolidated Appropriations Act of 2023 required that…

  • CMS Releases Updated Medicaid & CHIP Telehealth Toolkit, Includes State Best Practices and Behavioral Health Strategies

    Anne Dwyer

    This month, CMS released an updated State Medicaid and CHIP Telehealth Toolkit consolidating information from previous toolkits and providing additional guidance – as required by the Bipartisan Safer Communities Act – on issues from billing best practices to strategies for using telehealth in schools. In addition to FAQs on issues such as benefit flexibility, financing,…

  • If You Love Children, You Should Love these Medicaid/CHIP Policy Changes in 2024

    Hannah Green

    Before the new year slips from memory, I wanted to take stock of a few good things happening for kids covered by Medicaid and CHIP this year. Amidst all the dismal news about how nearly 4 million children have lost their coverage during the unwinding – many remain eligible but lost coverage due to red…

  • Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q4 2023

    Ella Mathews

    Q4 2023 was also the third quarter of the PHE “unwinding”—the redetermination of eligibility for all 86.7 million Medicaid enrollees following the expiration of the Public Health Emergency continuous coverage provision in March 2023. These redeterminations have resulted in the disenrollment of over 16 million Medicaid enrollees as of January 2024, which translates into a…

  • A Lifeline for Families of Children With Special Health Care Needs

    Guest

    By Gabby Benitez, Kristen Golden Testa and Nick Lutton Nine months after the start of a national effort to renew Americans’ Medicaid coverage, a tidal wave of people, including almost 200,000 children in California from June through October last year, lost their coverage – and an untold number may be joining them. Most disturbingly, this…

  • Marketplace Enrollment Surges Among Those Losing Medicaid Coverage During Unwinding

    Edwin Park

    As readers of Say Ahhh! know, I have been tracking monthly data (here, here, here, 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 during unwinding who then selected a marketplace plan. …

  • Medicaid Expansion in Georgia would Improve Maternal and Infant Health Outcomes

    Hannah Green

     One in ten Georgians report knowing someone who has died through pregnancy-related causes. An estimated 57% of Georgians have experienced or know someone who has experienced maternal morbidity. Over 70% of Georgians believe that prioritizing improvements in access to health insurance coverage would help to reduce maternal mortality. These statistics were shared at the…