Eligibility & Enrollment
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Arkansas ‘Private Option’ Model Doesn’t Make Sense for Pennsylvania
As readers of SayAhhh! know, Governor Corbett of Pennsylvania is currently revising a Section 1115 Medicaid waiver proposal to extend Medicaid coverage to the newly eligible low-income adults in his state. That would be great news if it weren’t such a problematic proposal (as I have blogged about before). The state took public comments on…
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How Do Updated 2014 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?
By Martha Heberlein Updated 2014 federal poverty thresholds were released on January 22nd and inquiring minds have been asking what they mean in terms of determining eligibility for Medicaid, CHIP, and premium tax credits. And the answer, as with so many things in our world is, “well, it depends.” Let’s start with premium tax credits…
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Rep. Waxman’s Legacy Includes Significant Improvements in Children’s Health Coverage
Like many of you, I will truly miss Representative Henry Waxman when he retires from Congress at the end of this term. I admire his work ethic, deep concern for others and tireless efforts to stand up for those who need his help the most. Most of all, I admire his ability to get things…
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Where Does EPSDT Stand in Post-ACA Medicaid Expansion 1115 Waivers?
In the last few months, CMS has approved Medicaid expansion 1115 waiver demonstrations in Arkansas, Iowa and Michigan. Pennsylvania has a draft 1115 waiver proposal to expand Medicaid out as well. One important question that has emerged is: How will states continue to provide EPSDT and other benefits to 19 and 20 year olds who…
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Arizona Risks Falling Even Further Behind in Children’s Coverage by Rolling Back CHIP
Tomorrow, approximately 14,000 children in Arizona will lose their CHIP coverage as the state becomes the first in the nation to substantially roll back most of its CHIP program – Arizona KidsCare II. To understand what’s going on in Arizona, we first need to review the state’s checkered history with the Children’s Health Insurance Program…
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NWLC’s Report Finds Troubling Health Disparities for Low-Income Uninsured Women in States that Have’t Expanded Medicaid Coverage
States that have not yet accepted Medicaid funding to offer coverage to more uninsured adults are doing a huge disservice to women, according to a new report by the National Women’s Law Center. The report found troubling disparities between low-income women with and without health insurance and identified an urgent need to expand coverage in…
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GAO Finds Similar Reported Access to Care Among CHIP, Medicaid, and Private Coverage; Some Variation in Service Use
By Joe Touschner As part of its comparison of CHIP to private coverage, the Government Accountability Office (GAO) was charged with evaluating CHIP enrollees’ access to care. At a high level, GAO’s findings confirm previous studies of access to care in public and private coverage: enrollees of both report having good access when asked if…
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GAO Releases Preliminary CHIP Check-In
By Joe Touschner A new study from the Government Accountability Office (GAO) takes an initial look at how CHIP compares to private health coverage for children. It examined benefits, costs, and access to care in CHIP and made some preliminary comparisons to health plans similar to those offered in marketplaces. GAO found that CHIP is…
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Express Lane Eligibility Has Proven Its Effectiveness – Time to Make it a Permanent Policy Option
Piloting new ways of doing things makes sense. It’s a way to test whether a concept or idea will work the way it’s envisioned, and fine-tune it based on actual experience. To this extent 13 states (AL, CO, GA, IA, LA, MD, ME, NJ, NY, OK, PA, SC, UT) have spent the past five years…
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Children’s Behavioral Health Care Use in Medicaid: Highlights from a National Analysis
By Kamala Allen and Taylor Hendricks, Center for Health Care Strategies “Eleven-year-old Angel has moved from one foster home to another since age six. His mother struggles with heroin addiction, his father is deceased, and he rarely sees his three siblings who live in separate foster homes. Angel has a hard time concentrating in school…
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Budget Deal Kicks “Medicaid Extenders” Down the Road, Adds DSH Delay
Earlier I wrote about progress in the Senate on the Medicare Sustainable Growth Rate (SGR) repeal, or “doc fix,” which passed the Finance committee with the Medicaid extenders intact. Since time was running out for the House and Senate to agree on the exact terms for a permanent SGR fix, the Murray-Ryan budget agreement on…
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Many Southern States Miss Opportunity to Address Health Disparities
By Tara Mancini A new report from the Kaiser Commission on Medicaid and the Uninsured (KCMU) indicates that a little more than half (53%) of uninsured people of color have family income at or below 138% and therefore should qualify for Medicaid in 2014 as the ACA originally intended. Yet, almost a third (30%) of…
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CCF Partners with Urban Institute and Packard on New Health Reform Survey
By Martha Heberlein Today, Health Affairs released a paper detailing a new (and in our opinion a very exciting!) survey – the Health Reform Monitoring Survey (HRMS) – designed by the Urban Institute. This internet-based survey is intended to provide rapid-cycle feedback on changes under the ACA. The goal is to replicate key outcome measures…
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Pennsylvania’s Medicaid Waiver Proposal Does Not Impress
Last Friday, Governor Corbett’s Administration released it’s Section 1115 waiver application draft. This initiates the process for the required 30-day state comment period that must precede the submission of the waiver request to the federal government. The state will be holding a series of public hearings and webinars with the final hearing in Harrisburg…
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Iowa Medicaid Expansion Waiver Approved!
Just in time for Christmas, and more importantly in time to get the program up and running by January 1st, federal CMS has granted Iowa’s request for two Section 1115 waivers to allow the state to pursue its own version of Medicaid expansion. This is good news for the more than 100,000 Iowans who stand…
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Translating Eligibility and Enrollment Lingo
My colleagues just released a helpful update on state progress in creating more consumer-friendly eligibility and enrollment systems. If you’re like me, when reading Medicaid eligibility terms like “MAGI conversion” and “flat file,” your mind wanders to a foreign money exchange or even a children’s book character—yes, the omnipresent Flat Stanley—rather than focusing on people…
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Handling Premiums with Care in Medicaid, CHIP and the Marketplace
In my former life as a CHIP director, I came to appreciate how tough it is for low-income families to make ends meet. In the hierarchy of needs, I think we all agree that paying the rent and utilities, putting food on the table, and making sure you can show up for work by having…
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Handle with Care: How Premiums Are Administered in Medicaid, CHIP and the Marketplace Matters
The evidence is clear that premiums that are unaffordable or charged at too low an income level are a barrier to enrollment and retention of health coverage. However, the approach to premium collection also plays an important role in helping low-income families and individuals secure and maintain coverage. In this new brief, CCF explores the…
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Extending Medicaid: Good for Parents, Great For Kids! Here’s Why
One of the best state approaches for covering the remaining low-income uninsured children is to put out the welcome mat for the whole family by extending Medicaid coverage for parents. While most low-income kids are currently eligible for Medicaid and CHIP, they continue to be disproportionately uninsured: in 2012, they were 45.1 percent of the…
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CMS Offers States Transitional Use of “Flat Files” for Medicaid/CHIP Enrollment
By Martha Heberlein Citing the ongoing delay in transferring Medicaid/CHIP applicants from the Federally Facilitated Marketplace (FFM) to states, CMS has given states the option to enroll new Medicaid applicants based on the “flat files,” as opposed to full applicant accounts, in the hopes of getting new applicants connected to coverage by January 1. To…