Redirecting Medicaid MCO Gains to Offset Network Provider Losses in the Time of COVID-19

2020 Q2 marked the arrival of the coronavirus pandemic, stay-at-home orders, school closures, social distancing, and a recession. Families put off going to the doctor’s office for routine, non-emergency care. Primary care physician practices and clinics that bill for each visit saw sharp drops in their revenues as patients stayed at home (pediatricians’ offices were…

July 27, 2020

By

Andy Schneider

Blog

A Tune-Up on Eligibility Rules and Application Process for Families with Immigrants

With the third open enrollment period firmly underway, assisters are racing to get eligible people covered, including many families with one or more immigrant member whom are often among the most complicated cases assisters see. Since nearly half of all uninsured children in America live in families with at least one immigrant member, enrolling families with…

November 24, 2015

By

Sonya Schwartz

Blog

Medicaid Drug Rebate Program News and Notes, 2024 Edition

Periodically I write up news on the Medicaid Drug Rebate Program (MDRP) and here’s another (albeit overdue) edition highlighting some recent MDRP policy developments: The Centers for Medicare and Medicaid Services (CMS) will not finalize its proposal to require manufacturers to “stack” discounts when determining best price under the MDRP. The best price requirement, which…

July 31, 2024

By

Edwin Park

Media Coverage

Teen Girls Would Pay the Ultimate Price Under the AHCA

Bustle By: Jon Hecht One of the most prominent aspects of the health care bill is the $880 billion cut to Medicaid, along with changes to the program which would force states to cap their spending at certain levels. It stands in contrast to the current system, in which Medicaid covers all health care needs of…

May 10, 2017

By

News Article

Research & Reports

An Explanation of Final Medicaid Managed Care and Access Rules

Executive Summary While the Centers for Medicare & Medicaid Services (CMS) has overseen the steady growth in Medicaid coverage over recent years, CMS has faced the additional challenges of ensuring that coverage truly leads to meaningful access to care and that there is strong oversight. CMS recently finalized two key regulations: “Ensuring Access to Medicaid…

August 7, 2024

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Blog

Florida Legislature’s Medicaid Folly

The Florida Legislature is about to make final decisions about the state’s budget in the next few weeks – decisions that are constructed on false fiscal assumptions — with reckless options on the table that would weaken the state’s health care system and lead to more uninsured Floridians if finalized. During what we all hope…

April 19, 2021

By

Joan Alker

Blog

Michigan Medicaid Evaluation Has Important Lessons for States Considering Work Requirements

On Monday, a team of researchers from the University of Michigan (who are the official evaluators of the Healthy Michigan Plan) published a study in the Journal of the American Medical Association (JAMA) on the employment status of the adult Medicaid expansion population in Michigan. In a survey of 4,090 expansion adults, researchers found that…

December 15, 2017

By

Joan Alker

Research & Reports

Child Medicaid Disenrollment Data Shows Wide Variation in State Performance as Continuous Coverage Pandemic Protections Lifted

Download the Full Report (PDF) Background During the COVID-19 public health emergency, states received increased federal Medicaid matching rates in exchange for a commitment to maintain continuous coverage for those enrolled in Medicaid. With the public health emergency winding down, as part of the Consolidated Appropriations Act (CAA), 2023, Congress ended the continuous coverage requirement…

May 2, 2024

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Research & Reports

BEING THE SECOND PART OF THE “WHITHER PREMIUM ASSISTANCE”

Welcome to Part 2 of my musings about the state of premium assistance. Part 1 left us with the teaser that CHIPRA includes new premium assistance options, which the new health reform law incorporates and expands to all Medicaid beneficiaries as of January 1, 2014. So let’s take some time to explore where things stand…

April 22, 2010

Blog

Georgetown CCF Welcomes National Medicaid Expert Andy Schneider to our Team

It is with great pleasure that I am able to share some wonderful news with SayAhhh! readers about the latest addition to our team here at Georgetown University’s Center for Children and Families. For Medicaid cognoscenti, Andy Schneider needs no introduction as there are few individuals who are more integral to the development of the Medicaid…

February 10, 2017

By

Joan Alker

Blog

CMS Should Withdraw Medicaid State Financing and Supplemental Payment Rule That Undercuts COVID-19 Relief Bill’s Enhanced Federal Medicaid Match

[Editor’s Note: On March 18, 2020 the Senate passed and the President signed into law the bipartisan Families First Coronavirus Response Act (H.R. 6201) after this blog was published.] Today (March 18, 2020), the Senate is expected to pass the House-passed coronavirus relief bill (H.R. 6201) and send it to the President’s desk. The bill…

March 18, 2020

By

Edwin Park

Data

Medicaid Coverage in Metro and Small Town/Rural Counties, 2023

Click on a state below to view rates of Medicaid coverage in Metro and Small Town/Rural counties. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New…

January 14, 2025

Blog

Unexpected Defeat of Repeal Bill Doesn’t Mean End of Threats to ACA Health Coverage

In the wake of the surprise defeat of the Senate’s effort to repeal and replace the Affordable Care Act (ACA), President Trump tweeted: “As I said from the beginning, let ObamaCare implode, then deal. Watch!” The Trump administration does in fact have considerable ability to undermine and even “implode” the ACA’s insurance marketplaces, independent of Congress.…

July 31, 2017

By

Sabrina Corlette

Projects

Keeping Kids Connected to Care During COVID-19

The American Academy of Pediatrics (AAP) and Georgetown University Center for Children and Families (CCF) have teamed up to protect children’s health and well-being with the launch of a joint project: “Keeping Kids Connected to Care During COVID-19 and Beyond”. AAP and CCF are working with Manatt Health, Family Voices and a network of children’s…

August 5, 2020

Blog

Kansas and Mississippi Medicaid Waivers Race to the Bottom: Most Vulnerable Families Targeted by Harmful Proposal

Medicaid is a critical part of health insurance coverage in the US, covering millions of children and their parents, seniors and individuals with disabilities. More than half of states have taken the Affordable Care Act option to expand Medicaid coverage to more low-income parents and childless adults. But some states are trying to move in…

December 1, 2017

By

Joan Alker

and

Suzanne Wikle

Blog

Senate Voting Rules and Budget Reconciliation Explained (Part 2)

In part 1 of this budget reconciliation refresher, I wrote about the basic rules for passing legislation in the House versus the Senate and how the budget reconciliation process allows certain legislation to move forward with approval from a simple majority of Senators rather than the usual three-fifths or 60-vote threshold. Now I’d like to…

January 27, 2021

By

Kelly Whitener

Blog

Post ACA, 3 Communities Respond to a Shifting Health Care Landscape for Newly Insured

The Affordable Care Act (ACA) has proven successful in meeting one of the law’s primary goals: to extend coverage to more Americans. Nearly 13 million people signed up for marketplace coverage in the 3rd open enrollment period, contributing to a dramatic reduction in the number of uninsured. But what has that coverage meant for helping…

April 8, 2016

By

JoAnn Volk

Blog

Weaponizing Program Integrity: A New Assault on Medicaid Expansion

CMS Administrator Seema Verma has never been a fan of the Affordable Care Act’s Medicaid expansion or the positive difference it has made in the lives of low-income Americans. In fact, ever since Congress refused to repeal the expansion and block grant the program in 2017, Administrator Verma has been trying to make it harder…

June 25, 2019

By

Andy Schneider

Blog

Final Medicaid Managed Care Rule Explained

CMS recently finalized two key regulations: “Ensuring Access to Medicaid Services” (Access Rule) and “Medicaid, CHIP Managed Care Access, Finance, and Quality” (Managed Care Rule), aimed at improving access to care in Medicaid across delivery systems (fee-for-service and managed care) and authorities (state plan and waiver services). The Managed Care Rule addresses five primary areas:…

May 3, 2024

By

Leonardo Cuello

Blog

A Conversation on Meaningful Family Engagement, from Clinical Care to Health Policy

For families of children who have complex medical conditions, equal partnership in multiple levels of care is essential to positive outcomes for their children. A recent article Families of Children With Medical Complexity: A View From the Front Lines provides an overview of care management from the perspective of parents who have children with complex…

May 29, 2018

By

Allison Gray

and

Adam Searing

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