Financing
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Radically Restructuring Medicaid Would be Bad for Kids
While most press coverage has focused on repealing the Affordable Care Act and scaling back the Medicaid expansion for adults, a less well-known but extremely damaging effort under consideration by Congress would radically restructure Medicaid financing. Proposals would do this through a block grant or per capita cap designed to save money by limiting federal contributions. (Kaiser just put…
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How Restructuring Medicaid Could Affect Children
More than one-third of America’s children rely on Medicaid for their health care, and more than half of Medicaid recipients are children. Medicaid’s existing structure has helped states respond to every economic downturn, natural disaster, epidemic or innovative treatment since the program was enacted in 1965. As recently as last year, Congress put forth proposals…
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Growth In Medicaid Spending Per Enrollee Is Low
A new fact sheet from the Commonwealth Fund, “Essential Facts About Health Reform Alternatives: Block Granting Medicaid,” makes compelling arguments about the dangers of block granting Medicaid. States would receive a fixed, preset amount of federal funds that would not change if the number of enrollees increase or if the cost of services rise. This…
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TANF, CCDBG Demonstrate That Block Grants And Per Capita Caps Won’t Work For Medicaid
By Suzanne Wikle and Jessica Gehr of CLASP Congress is reportedly again considering proposals to change the fundamental structure of Medicaid, including by turning it into a block grant program or providing fixed allotments per recipient (“per capita caps”). Such proposals have been made repeatedly over the years, but consistently rejected. However, other programs with…
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Risky Business: Health Actuaries Assess the Individual Market and Rates
By Rachel Schwab, originally posted on CHIRblog Health reform is often a series of what-ifs. As we wade into the uncertainty of congressional action, Executive Orders, and “the greatest replacement plan ever,” consumers and insurers alike have to hedge their bets and carefully calculate the impact of a number of unknown outcomes. Unfortunately sometimes it…
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Uncertain Future for the Affordable Care Act Leads Insurers to Rethink Participation, Prices
By Sabrina Corlette, Kevin Lucia, Justin Giovannelli and Dania Palanker, originally posted on CHIRblog The Affordable Care Act (ACA) is facing an uncertain future, with a new President and Congress committed to its repeal. Upcoming policy debates could have a dramatic impact on the individual health insurance market, especially the ACA’s marketplaces. While millions of…
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CCF Hosts Webinar on Medicaid and CHIP Financing
After months of vowing to repeal the Affordable Care Act, Congress and the new administration are now signaling that they’re not going to stop there. Policymakers are already talking about capping or block granting Medicaid and holding up needed funding for the Children’s Health Insurance Program. Such changes would leave states struggling to meet the…
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ACA Repeal Would Lavish Medicare Tax Cuts on 400 Highest-Income Households
By Brandon Debot, Chye-Ching Huang, and Chuck Marr, originally posted by the Center on Budget and Policy Priorities Republicans’ planned bill to repeal the Affordable Care Act (ACA), which is expected to be similar to the repeal bill that President Obama vetoed in January 2016, would provide an immediate windfall tax cut to the highest-income Americans…
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Research Shows Fewer Jobs, Greater Financial Burden on Providers, States, & Local Governments if ACA Repealed
Taken together, three recent papers provide a sobering look at the extensive economic consequences for providers if the Affordable Care Act (ACA) is repealed. Just last week, the Robert Wood Johnson Foundation published “The Impact on Health Care Providers of Partial ACA Repeal through Reconciliation,” an analysis from the Urban Institute. Their main finding? Repeal…
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For Mental Health Services, Would ACA Repeal Turn ‘Warm Handoff’ into Cold Shoulder?
One of the few points of bipartisan agreement in Congress last year was finding ways to support mental health services. The 21st Century Cures Act passed in Congress and signed by the President just last month took steps to integrate mental health into primary care services, expand the pool of providers and improve the interactions…
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Report Recommends a New Child-Centered Approach to Value-Based Payment in Medicaid
By Kate Breslin, Schuyler Center for Analysis and Advocacy and Andrea G. Cohen, United Hospital Fund As part of its Delivery System Reform Incentive Payment (DSRIP) waiver, New York Medicaid has set an ambitious goal to rapidly implement value-based payment across 80 percent of managed care payments by 2020. For all of the challenges associated with this huge…
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New Florida Legal Services Report Examines Financial Challenges to Health Care System
By Miriam Harmatz, Florida Legal Services My colleague, Charlotte Cassel, and I spend a lot of time explaining changes to Florida’s major supplemental payment program, the Low Income Pool (LIP) and how those changes impact individual counties. FLS Reports. Before we started this endeavor, I pulled out notes from training by iconic poverty and health…
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Tax Policy, Budget Cuts Pose Health Risk to Kansas Children
By Amanda Gress, Kansas Action for Children Kansas policymakers’ refusal to revisit deep income tax cuts has once again harmed the health of Kansas children. In May, Governor Brownback announced a 4% reduction in reimbursement rates for KanCare, the state’s managed-care Medicaid program. These choices will ultimately make it more difficult for Kansas children covered…
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Embracing an Opportunity to Measure Value in Children’s Health Care
By Suzanne Brundage, originally posted on www.uhfnyc.org Most people in the child health community—and almost assuredly all readers of “Say Ahhh!”—are aware of the ways in which children’s health and their use of health care services differ from those of the adult population. Key differences include the prominence of prevention efforts in children’s health, the relatively…
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Beyond the Reduction in Uncompensated Care: Medicaid Expansion Is Having a Positive Impact on Safety Net Hospitals and Clinics
More than two years after the onset of expanded Medicaid coverage, significant differences are emerging between states that opted to expand Medicaid and those that did not. This report contains the findings of telephone interviews with eleven leaders of hospital systems and federally qualified health centers (FQHCs) in seven states. Three of the states where we conducted interviews…
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New Study Shows Medicaid Expansion Reduces Household Debt
Medicaid expansion has led to declines in the rate of uninsurance, improved access to care for enrollees, and financial savings for states. A new study points to an additional benefit to newly eligible Medicaid enrollees: lowering debt. Prior studies indicate that Medicaid reduces medical debt, but a new study examined the impact of Medicaid expansion…
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How Cuts to Safety Net Hospitals Impact the Uninsured in a State that Rejected Medicaid Expansion Funding
by Miriam Harmatz, Florida Legal Services Much has been written—from blogs to briefs—documenting the tremendous positive impacts of Medicaid expansion. Less well-documented are the negative impacts that flow from rejecting expansion. Obviously, non-expansion states fail to reap the profound benefits of expansion. But they are not just failing to move forward with the expansion’s huge…
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A Primer on Health Care Quality Measurement and Improvement for Children in Medicaid and CHIP
When I was the CHIP Director in New Hampshire, we thought that achieving a 95% rate of coverage for kids was the high bar. As a country, we are not only closing in on that goal, but leading states have raised the bar to 98% and beyond. And while we must continue to eliminate disparities…
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Measuring and Improving Health Care Quality for Children in Medicaid and CHIP: A Primer for Child Health Stakeholders
A large body of evidence shows that, compared to low-income uninsured children, Medicaid has been highly successful in providing children with a usual source of care and regular well-child care while significantly reducing unmet or delayed needs for medical care, dental care, and prescription drugs due to costs. Nonetheless, quality improvement centers on the notion…
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Oklahoma’s Proposed Medicaid Cut Won’t Pass Federal Muster
by Jesse Cross-Call, originally posted on cbpp.org Oklahoma’s Senate is considering legislation, which its House passed last week, to end Medicaid coverage for 110,000 very low-income parents. But even if Oklahoma enacts the legislation, federal officials almost certainly won’t grant the needed federal approval to move forward. By federal law, states must provide Medicaid coverage…
