Blog
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Lessons in the Defeat of Tennessee Governor Haslam’s Medicaid Expansion Plan
In a disappointing committee vote yesterday Tennessee Governor Bill Haslam’s carefully crafted state-specific plan for using federal Medicaid expansion dollars was rejected. A state budget cost-neutral financing mechanism through hospital fees and multiple other provisions that would have made the plan a significant showcase of conservative health policy ideas were not enough to obtain legislative…
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Getting MAGI Right: Changes to Income Counting Rules in Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate things, there are…
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How Do Updated 2015 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?
Over the weekend, Healthcare.gov uploaded the new 2015 federal poverty levels (FPL) to use in assessing eligibility for Medicaid and CHIP. What does this mean to consumers applying for coverage? Let’s start with eligibility for Marketplace subsidies. For 2015 calendar year coverage, regardless of when someone applies or enrolls, eligibility is based on the 2014…
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Getting MAGI Right: When Does Social Security Income Count?
UPDATED VERSION HERE Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate…
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Millions Gain Coverage Through Affordable Care Act – What’s Medicaid Got to Do With It?
Last week, the Centers for Medicare and Medicaid Services (CMS) released Medicaid enrollment data that sheds light into how many people have gained Medicaid coverage though the Affordable Care Act. According to CMS, more than 3.2 million Medicaid beneficiaries were able to sign up for Medicaid in 22 expansion states because they fell into the…
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Do Workplace Wellness Programs Actually Improve Healthy Behaviors?
If you’re like most people, you started 2015 with a list of New Year’s resolutions. And if you have, chances are the list of resolutions includes something along the lines of lose weight, get fit, or maybe even quit smoking. It’s also likely few of those resolutions will be met or even still be around…
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Need Help Learning Eligibility Rules and Application Process for Families with Immigrants?
With less than two weeks left until the end of Open Enrollment two, assisters are racing to get everyone covered, including families with immigrants, often among the most difficult cases. I recently had a chance to help train more than 800 consumer assisters about how to overcome barriers to eligibility and enrollment for health coverage programs…
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Getting MAGI Right: An Assisters Worksheet for Determining Household Size in Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes, but to further complicate things, there are some differences that apply…
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President’s Proposed Budget: Four More Years of CHIP
It would be great this Groundhog’s Day if Pensetucky Pete’s shadow also allowed us to forecast additional years of CHIP. But today we did get an important signal from the Administration that CHIP must remain a strong player in the system of children’s coverage for the foreseeable future. President Obama’s proposed budget included four additional…
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Getting MAGI Right: Exceptions for Who Counts in the Household for Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate things, there are…
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Study: Charging Medicaid Patients Co-Pays for Unnecessary Use of ER Does Not Decrease ER Visits
This was the interesting conclusion last week from a comprehensive study in the Journal of the American Medical Association. Researchers compared emergency department use by Medicaid patients from 2001-2010 in eight states that impose copayments for nonurgent use of the emergency department with ten states having zero emergency department copayments. The study involved over 10,000…
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Getting MAGI Right: Differences in Medicaid and CHIP Add Complexity
Next to the fact that millions of people are gaining health insurance, one of my favorite aspects of the ACA is its transformation of Medicaid – moving Medicaid into a modern era by harnessing technology and tapping trusted sources of electronic data to determine eligibility in real time. Launching a new high-performing eligibility system is…
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“Budget Neutral” Funding for State Share of Medicaid Expansion: Hospital Fees and Taxes?
As new plans to expand Medicaid are proposed, one issue increasingly coming up is the idea of “cost neutrality” to state budgets when creating the framework for a state expansion. The Affordable Care Act provided 100% federal funding for state expansions through 2016 but after that date states must pay a small graduated share of…
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Anticipated Cuts to Uncompensated Care Funds Increase Pressure on Florida to Expand Medicaid
Today I had the pleasure of joining the League of Women Voters of Florida and Florida Legal Services on a conference call to discuss a topic of utmost importance – the decision facing Florida’s policy makers as to whether or not to expand Medicaid – especially in light of the scheduled expiration of Florida’s Low…
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Indiana Becomes the 29th State (Including DC) to Expand Medicaid
[Editor’s Note: The terms and conditions and letter issued by federal CMS are available through these links: agreement, special terms and conditions and letter.] Today Governor Mike Pence received approval from federal CMS for a Section 1115 waiver to implement his Healthy Indiana Plan (HIP2.0) and extend coverage to as many as 350,000 Hoosiers –…
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Indiana Agreement Wins the Award for Bureaucratic Complexity and Red Tape
I am still waiting for paper but here is what I know about Indiana so far. The good news is that Indiana becomes the 29th state (including D.C.) to extend Medicaid coverage. The less than good news is that this is an enormously complicated program which will likely prevent some low-income adults from getting the…
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Medicaid Primary Care Rate Bump Increases Access, study finds
By Sophia Duong The Medicaid primary care bump now joins the likes of Emily Dickinson and Vincent Van Gogh – those that received credit only after their passing. After two years of raising Medicaid primary care rates up to Medicare levels, the rate bump expired on December 31, 2014. But weeks after its expiration, a…
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CMS Clarifies Health Coverage Options for Low-Income Pregnant Women
It’s critical that expectant mothers have access to comprehensive, affordable coverage and continuity of care during this critical time of life. The Affordable Care Act expanded coverage options for pregnant women but the intersection of these changes to the law with other state and federal policies is a bit confusing to untangle. Recent federal guidance…
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A Fond Farewell to CCF
By Joe Touschner When I came to CCF in March of 2008, Senators Obama and Clinton were talking a lot about health reform on the campaign trail, but the Affordable Care Act was unwritten and still two years away from enactment. The median income eligibility threshold for children’s coverage across the states was 200% of…
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Kaiser Family Foundation & CCF Release 50-State Survey on Medicaid and CHIP
It’s that time again – the release of the annual 50-state survey on Medicaid and CHIP eligibility, enrollment, renewal and cost-sharing policies conducted by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families. Today, my co-authors from Kaiser – Samantha Artiga, Jessica Stephens, and Alexandra…