Federal
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States Innovation Waivers under the ACA: A Closer Look at the Updated Federal Guidance and State Proposals
By Kevin Lucia, Justin Giovannelli, Sean Miskell and Ashley Williams. Originally posted on the CHIRblog. The Affordable Care Act (ACA) established a framework—including now-familiar elements like insurance marketplaces and premium tax credits—to expand access to affordable, comprehensive health insurance coverage. However, the law also gives states a chance to realize these goals using alternative solutions.…
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Commonwealth Fund Tool Demonstrates Effects of State Efforts to Expand Coverage and Improve Enrollment
By Sean Miskell Comparing outcomes across states provides an opportunity to consider how state-specific approaches to administering their health programs provide coverage to their residents and help them stay enrolled. Say Ahhh! readers certainly know that we like our 50-state tables here at CCF. The Commonwealth Fund has updated its interactive tool that allows users…
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Administration’s Budget Proposal Would Make Medicaid Expansion an Even Better Deal for Wisconsin and Other States
By Jon Peacock and Sashi Gregory, Wisconsin Council on Children and Families The proposed budget released this week by President Obama would make the expansion of Medicaid an even better deal for states like Wisconsin that have not yet taken up the option. If Wisconsin expanded BadgerCare (Wisconsin’s Medicaid program) eligibility in January 2017, the…
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2016 Federal Poverty Levels Are Out; What Does This Mean for the Marketplace and Medicaid?
Last week, the 2016 federal poverty levels (FPL) were published in the federal register. How does this impact consumers applying for coverage through the Marketplace, Medicaid or CHIP? Let’s start with eligibility for Marketplace subsidies. For 2016 calendar year coverage, regardless of when someone applies or enrolls, eligibility is based on the 2015 FPL levels.…
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Little Known Provision Keeps Kids From Slipping Through Cracks Due to Differences in Eligibility Rules
For the most part, the Affordable Care Act aligns the way that Medicaid determines eligibility based on the same Modified Adjusted Gross Income (MAGI) rules used to determine eligibility for financial assistance in the Marketplace. But there are exceptions in Medicaid as I outlined in this blog. The differences can mean that an individual is…
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Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey
Executive Summary January 2016 marks the end of the second full year of implementation of the Affordable Care Act’s (ACA) key coverage provisions. This 14th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies provides a point-in-time snapshot of policies as of January 2016 and identifies changes in policies that occurred…
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With gains in health coverage, Latino children also gain more equitable opportunities.
By Steven Lopez, Health Policy Project, NCLR and Sonya Scwhartz, Georgetown University Center for Children and Families Our new report with National Council of La Raza finds that the uninsured rate for Hispanic kids hit a historic low and the coverage gap between Hispanic kids and their peers narrowed considerably in 2014, the year the Affordable Care…
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Premium Assistance and Wrapped Benefits Part 2: A Startling Discovery
As I blogged about last week, our recent report with co-authors at the Kaiser Commission on Medicaid and the Uninsured looked at wrapped benefits and how they are working in selected Section 1906 premium assistance programs. The most startling discovery to me was the finding that families have no cost-sharing protections in the programs we…
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Senate reconciliation bill repeals key children’s health provisions
So despite a bipartisan CHIP extension earlier this year, it appears that children’s coverage is not as popular as we may have thought. In fact, if the reconciliation bill as passed becomes law there is a good reason to believe that millions of children would become uninsured; almost assuredly the historic and steady reductions in the…
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Medicaid Premium Assistance Programs: What Information is Available About Benefit and Cost-Sharing Wrap-Around Coverage?
States have long used Medicaid funds as premium assistance to purchase private health insurance for beneficiaries as an alternative to providing coverage directly through the state Medicaid program. States using premium assistance generally must provide wrap-around benefits and cost-sharing protections so that Medicaid beneficiaries receiving private coverage will not have access to fewer benefits or…
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More Evidence that Medicaid Expansion Helps State Budgets
Recently, Kaiser Family Foundation released a report on Medicaid Enrollment & Spending Growth for FY 2015 and 2016. There is a lot of interesting data in the report, but the stand out finding confirms what we already know: Medicaid expansion is good for state budgets and leads to increases in coverage. Medicaid Enrollment is up…
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ACA Helps Bring Child Uninsured Rate Down To New Record Low
This year’s American Community Survey (ACS) data from 2014 provide a first look at how the implementation of the ACA is affecting coverage rates for children – both nationwide and in all 50 states and the District of Columbia. Our analysis looks at the profile of uninsured children in 2014 and examines rates of change…
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More than 400,000 Lose Marketplace Coverage: Let’s Fix This and Keep People Covered
Along with the headline yesterday that nearly 10 million consumers paid their premiums and had an active marketplace health insurance policy as of the end of June 2015, there was very disappointing news. The federally facilitated marketplace (FFM) already terminated overage for about 423,000 people with 2015 coverage who had immigration or citizenship status data matching…
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Seven Steps for Children’s Advocates Reviewing Essential Health Benefit Benchmarks
HHS recently posted the proposed 2017 Essential Health Benefit (EHB) benchmark benefit plans (BBP) and supporting documents for the 50 states and DC. Though the 30-day public comment period is short, it provides an important opportunity for state advocates and stakeholders to review their state’s EHB BBP and raise any concerns before final federal approval.…
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Early Returns From Medicaid Expansion: Studies Find New Enrollees Are Accessing Needed Care
One of the key arguments that opponents of expanding Medicaid make is that there is no point in doing so because access is so poor in Medicaid that it won’t actually help the intended beneficiaries get the care they need. There is certainly room for improvement in access to care for Medicaid beneficiaries, and it…
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Consumer Assistance and Tools Needed to Ensure that All Eligible Marketplace Enrollees Get Cost-Sharing Reductions
Many of us have been asking this question for months: How many people who purchased coverage through the Marketplaces missed out on lower cost sharing because they did not enroll in a Silver plan? Now we have an estimate thanks to a new analysis by Avalere Health. Avalere’s headline – “More than 2 Million Exchange Enrollees…
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Proposed Rule Will Improve Medicaid Managed Care
After much anticipation, CMS published a notice of proposed rulemaking on Medicaid and CHIP managed care early this summer. The proposed rule includes many changes centering around five principles: alignment with other coverage options; delivery system reform; payment and accountability improvements; beneficiary protections; and modernizing regulatory requirements and improving the quality of care. It also…
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State and National Experts Convene to Discuss Early Childhood Developmental Screenings and Referrals
By Carrie Fitzgerald, Vice President of Children’s Health Programs at First Focus, Here’s something almost everyone who reads this blog already knows: the first three years of a child’s life are a critical time for brain development. Our brains are most adaptable during early childhood, and early intervention and treatment for conditions, disorders, and developmental…
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Medicaid Provides an Excellent Long-Term Return on Investment
By Alisa Chester and Joan Alker As our nation marks Medicaid’s 50th anniversary of service to the nation this week, it’s a good time to reflect on how this federal-state partnership program is making a difference – especially for children and families. As has been widely discussed, Medicaid has been instrumental to our nation’s historic…
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Medicaid at 50: A Look at the Long-Term Benefits of Childhood Medicaid
An emerging body of research underscores the significant role that Medicaid plays as a source of health coverage and financial protection for children and families—the benefits of which last through adulthood. New data highlight striking examples of the long-term effects of Medicaid—including better health, lower rates of mortality, better educational and economic outcomes, and many…