Financing
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IRS Issues Guidance on Overlapping Medicaid and Marketplace Coverage
At last, we have IRS guidance informing consumers and tax preparers about issues with overlapping coverage through Medicaid and the Marketplace. I described this problem in a recent blog, highlighting the confusion that could result from 1095 forms showing dual coverage in Medicaid and the Marketplace. We have been concerned that during the tax reconciliation…
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CMS Releases State-by-State Designations of Whether Certain Medicaid Categories Meet Minimum Essential Coverage Standards
The long-awaited assessment of whether certain Medicaid coverage categories meet minimum essential coverage (MEC) standards is out. Why is this important? This list serves two purposes: Individuals eligible for non-MEC Medicaid can qualify for premium tax credits and cost-sharing reductions. Individuals with non-MEC Medicaid coverage know whether they need to secure MEC to avoid 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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Medicaid: A Sound Investment for Kids, Their Families and Their Futures
While our attention has been necessarily focused on extending CHIP funding (and working on the best ways to take advantage of the funding boost that came with it), Congress is engaged in another exercise that demands the attention of children’s health advocates. As in recent years, Medicaid is on the chopping block during budget negotiations,…
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Broad Wisconsin Budget Coalition Backs BadgerCare Expansion
By Jon Peacock, Wisconsin Coalition on Children and Families Sooner or later, Wisconsin is going to expand its Medicaid coverage, known as “BadgerCare,” to include all adults up to 138% of the federal poverty level (FPL). The strong public support for expanding coverage and the substantial financial benefits of accepting increased federal funding will eventually…
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Celebrate or Condemn Enrollment Success? Affordable Care Act Critics Can’t Decide
Health care policy debates can often be confusing but the rapidly shifting positions in the latest tempest on Medicaid and the Affordable Care Act are harder to follow than a ping-pong ball. For background one has to travel back to 2013 as major glitches in the healthcare.gov website were adversely affecting initial enrollment in the…
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GAO Report: Small Share of Medicaid Beneficiaries Account for Large Share of Cost
According to a study by the Government Accountability Office (GAO) – a congressional watchdog tasked with reporting on government programs for Congress – a small subset of Medicaid beneficiaries account for a disproportionately large share of Medicaid expenditures. Medicaid covers the very vulnerable populations of low-income people – many with disabilities – with high health…
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Florida’s Medicaid Budget: Just the Facts
In Florida, as in other states, there is a great deal of misinformation about how much the state pays for Medicaid. The program is jointly administered by both states and the federal government, and the feds pay for a majority of Medicaid’s costs in all states. However, some of Medicaid’s opponents obscure the federal government’s…
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Permanent 90% Federal Funding for IT Systems Is a Must For States to Achieve Medicaid Modernization
Medicaid modernization is a popular term used by states to describe how they are moving into the digital age to streamline eligibility and enrollment and improve operational efficiency. Technology is at the center of this transformation but the fact that many states have held on to 30-year old mainframe systems suggests that states won’t keep…
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Armstrong v. Exceptional Child—The Supreme Court’s “Fairest Reading” Really Isn’t Fair
By Jane Perkins, Legal Director of National Health Law Program In 2009, the Exceptional Child Center and other providers of in-home supportive services for people with disabilities sued the Idaho Medicaid Director, Richard Armstrong, on the grounds that they were not being paid enough. According to the record in the case, the state set the providers’ rates…
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Medicaid Block Grant Plan Resurfaces in Budget Proposals – Would Shift Costs to States
By Sean Miskell Though my creative side longs to contribute novel analysis and insight to the health policy world, too often reality makes doing so difficult. Such is the case this week, as both the House and Senate Budget Committee have submitted proposals that would restructure Medicaid as a block grant to states and repeal…
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The Importance of Medicaid Expansion to Improve Children’s Health Insurance Rates
By Alisa Chester and Sarah Koslov This week, two important studies confirmed our understanding that improving access to Medicaid and CHIP for children is a financially sound public investment that not only leads to greater health coverage rates but also results in increased college attendance, lower mortality rates, and higher earned wages. Together, the research…
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How Much is the Federal Government Spending on Children?
December’s issue of Health Affairs is dedicated to the subject of children’s health, particularly how children fare in the national health care system. The Scheduled Squeeze On Children’s Programs: Tracking The Implications of Projected Federal Spending Patterns, written by Urban Institute scholars C. Eugene Steuerle and Julia B. Isaacs, reviews how the federal government funds…
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No Tricks Here, CMS Treats States with Permanent Enhanced Funding for Medicaid Eligibility and Enrollment Systems
There could hardly be a sweeter treat for state Medicaid agencies than to learn that CMS is proposing to the make permanent the enhanced federal funding match of 90 percent for Medicaid eligibility and enrollment systems and a 3-year extension on certain cost-allocation requirements. It was a big deal when CMS first proposed the 90/10…
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Tracking Medicaid Enrollment and Spending
By Joe Touschner Each year, the Kaiser Commission on Medicaid and the Uninsured reports on the findings from its survey of budgets and enrollment among state Medicaid programs. (The budget survey is not to be confused with the Kaiser-Georgetown CCF survey of Medicaid and CHIP eligibility and enrollment policies coming in January). This year’s edition…
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New Kaiser Survey Finds More States Intend to Extend Primary Care Rate Increase
By Sophia Duong In a previous post, I summarized the initiatives taken by Congress and states to extend the payment rate increase for primary care services, set to expire on December 31, 2014. At the time, six states were reported to finance the primary care bump through 2015 with their own state funds. Now, Kaiser…
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Medicaid Matters For Children: Alabama’s Investment in Extending the Medicaid Payment Increase
By Dr. Marsha Raulerson, Fellow of the American Academy of Pediatrics Across the country, Medicaid and the Children’s Health Insurance Program (CHIP) provide health coverage to more than 43 million children, including half of all low-income children in the United States. This summer, I cared for one of those children. In August, a 17 year old…
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Medicaid Primary Care Payment Rate Bump Is Worth Extending
By Judy Solomon, Center on Budget and Policy Priorities An increase in Medicaid primary care payment rates that was included in health reform is scheduled to expire at the end of this year. But with the need for cost-effective Medicaid primary care rising across the country, the current physician rates should be maintained — and…
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Florida Legislature Adjourns with Unfinished Medicaid Business: Federal Hospital Funding to Run Out in 2015 Putting the Pressure on For Next Year
The Florida legislature adjourned for 2014 without accepting the federal Medicaid funding on the table to extend coverage to as many as a million Floridians who would have been eligible. According to the state’s Social Services Estimating Conference, for the current fiscal year (which will end on June 30, the state could have received $1,258,054,808…
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Medicaid Option: The Good Deal for States is Better than Expected
By Edwin Park, Center on Budget and Policy Priorities In a little-noticed finding in last week’s Congressional Budget Office (CBO) report on health reform, CBO sharply lowered its estimates of how much the Medicaid expansion will cost states. We’ve noted repeatedly that the federal government will cover the large bulk of the expansion’s cost. As our new report explains, these new…