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Eligibility & Enrollment

  • Are States Ready to Implement HR 1 and Medicaid Work Reporting Requirements?

    Tricia Brooks

    Key Findings Introduction On July 4, 2025, President Trump signed into law HR 1 (P.L. 119-21), the massive budget reconciliation bill that cuts more than $1 trillion from Medicaid and Marketplace health coverage. The law strips coverage from many lawfully residing immigrants, ties the hands of states to raise revenue to cover the state share…

  • Tracking State Readiness to Implement HR 1

    CCFadmin

    This tracker will report on eight state-reported Medicaid and CHIP performance indicators. The analysis of state data is displayed in national maps for the most recent quarter broken into four quartiles with the top quartile reflecting the highest performing states. To smooth out monthly anomalies in state workload and allow for tracking these metrics over time,…

  • New CHIP Protections are In Effect Now Despite Congressional Efforts to Eliminate Them

    Joan Alker

    During the legislative process, most of the talk was about Medicaid cuts, but we highlighted that the Children’s Health Insurance Program (CHIP) would not be spared if the budget reconciliation bill (HR 1) placed a moratorium on all provisions of the Eligibility and Enrollment Rule (E&E rule) finalized in April 2024. Thankfully, due to likely…

  • Medicaid, CHIP, and Affordable Care Act Marketplace Cuts and Other Health Provisions in the Budget Reconciliation Law, Explained

    Edwin Park

    Editor’s Note: this brief was updated on August 13, 2025 to reflect additional Congressional Budget Office coverage estimates of the reconciliation law issued on August 11, 2025 In partnership with On July 4, 2025, President Trump signed the Congressional Republican budget reconciliation bill into law (H.R. 1 or P.L. 119-21 which was previously entitled the…

  • Truth to Power:  A Republican Senator Stands Up for Medicaid and His Constituents; Then Announces Retirement

    Joan Alker

    With Vice President breaking the tie, the U.S. Senate just voted 50-50 “One Big Beautiful Bill Act”, the crown jewel of President Trump’s legislative agenda.  With final text not even available to assess, and presumably not even read by the 50 Senators who voted for it, three Republican Senators voted no (Paul (KY), Collins (ME),…

  • Webinar and Report Release: Medicaid Key to Maternal and Infant Health in Rural America

    CCFadmin

    Georgetown University CCF shared a new report with state-by-state data on Medicaid coverage of women of reproductive age and how cuts could impact their access to obstetric care in small towns and rural areas. Medicaid plays a larger role in providing health coverage to people living in small towns and rural communities than it does…

  • Rescinding the Eligibility and Enrollment Rule Would Thwart Efforts to Improve Efficiency in Medicaid and Efforts to Reduce Improper Payments

    Cathy Hope

    Congressional leaders have repeatedly said they are going to protect the most vulnerable from a loss of Medicaid coverage and focus on addressing “waste, fraud, and abuse” but rescinding the Eligibility and Enrollment rule would do neither. The Eligibility and Enrollment Rule (E&E rule) finalized by the Biden Administration in April 2024 is on the…

  • Thinking Frequent Medicaid Redeterminations Won’t Hurt Children’s Health Insurance? Take a look at What Happened in Texas.

    Melody Emenyonu

    Nearly half (47%) of the 79 million people who get their health insurance through Medicaid are children. To ensure continuity of coverage for children, Congress took action to protect children’s access to health insurance by requiring states to provide a full year of continuous coverage in Medicaid to children beginning in 2024. But will children’s…

  • 2025 Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies Survey Released by KFF and CCF

    Allexa Gardner

    During the unwinding of the COVID-related freeze on disenrollments in Medicaid, states were required to renew health insurance for all 94 million enrollees. The focus on Medicaid renewal processes during the unwinding revealed their complexity and inefficiencies in the system. With states facing an unprecedented volume of work and eligibility worker shortages, CMS provided new…

  • Medicaid Work Reporting Requirements: More than Meets the Eye

    Andy Schneider

    Republicans from President Trump on down are trying to hide the ball on how much they want to cut federal Medicaid payments to states and how they would go about doing so. But as my colleague Edwin Park has explained, they are working from the same playbook as they used in 2017 during the first…

  • Medicaid and CHIP Rules on Chopping Block

    Kelly Whitener

    As my colleague Edwin Park has written, the House Budget Committee “menu” of Medicaid cuts includes rescinding regulations promulgated by the Biden Administration. Of particular interest to readers of SayAhhh!, the menu includes rescinding the Medicaid and CHIP eligibility and enrollment rule and the two companion rules on improving access to care in fee-for-service and…

  • Medicaid/CHIP Coverage in Alabama Congressional Districts, 2023

    CCFadmin

    [Note: data reflect boundaries in effect for the 118th Congress. Districts in Alabama were redrawn for the 119th Congress but are not depicted below.]

  • What’s New for the 2025 Plan Year Open Enrollment

    Sabrina Corlette

    As the Affordable Care Act Marketplaces enter their 12th year, enrollment is at an unprecedented high, insurer competition is robust, and four out of five Marketplace enrollees can find a plan for $10 per month or less. This has also been a year of relative stability, without dramatic policy reforms or market disruptions. However, there are several…

  • State Momentum, New Tools, Implementation Questions on Multi-Year Continuous Eligibility

    Melody Emenyonu

    CCF and its founders have long raised the opportunity to provide multi-year continuous eligibility for young children in Medicaid and CHIP, and have tracked its progress since Oregon and Washington first proposed the policy for children from birth to kindergarten in 2022. (See our latest map and resources to track state progress for children.) Our…

  • CMS Expresses Concern over States with Large Shares of Application Backlogs

    Allexa Gardner

    Much has been written about the enormous task state agencies have faced as they returned to routine operations during the unwinding of the Medicaid continuous enrollment requirement. While the primary focus (rightfully) has been around renewals and the renewal process, states have other eligibility and enrollment operational responsibilities including processing applications for new applicants or…

  • 2024 Survey of Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies Shows Gains in Child and Maternal Health Coverage

    Hannah Green

    Highlights of the 2024 Survey of Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies, conducted by KFF and Georgetown CCF, were presented in a webinar today featuring federal and state officials from North Carolina and Ohio. This marks the 22nd annual report on state policies for eligibility, enrollment, and renewal processes, which this year includes…

  • Wondering what’s in the recent Medicaid and CHIP eligibility and enrollment rule?

    Hannah Green

    On April 2, 2024, the Centers for Medicare & Medicaid Services (CMS) published the second part of a two-part final rule that simplifies the eligibility and enrollment processes for Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). The rule eliminates certain access barriers for children enrolled in CHIP; makes transitions…

  • 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. …

  • Federal Poverty Levels Rise 4.1 Percent on Average

    Hannah Green

    HHS has released the 2024 federal poverty levels (FPLs) that will be used for means-tested public benefits, including Medicaid and CHIP. This means the annual poverty level for a family of three has increased to $25,820 up from $24,860 in 2023. The poverty level for an individual has increased from $14,580 to $15,060. It’s important…

  • Transitional Medical Assistance (TMA) and the Unwinding

    Andy Schneider

    Late last month, CMS released long-awaited guidance on Medicaid coverage for low-income working parents in the context of the unwinding of continuous coverage. Technically, this coverage is a mandatory eligibility category known as transitional medical assistance, or TMA, because it was originally designed to help parents transition from Medicaid to private insurance coverage through the…