In its first twelve months, the Biden administration has been unwinding the anti-Medicaid actions taken by its predecessor. The unwinding has been slow and methodical, and it is not yet finished. In part, this is because the new management at CMS has necessarily been focused on responding to the COVID-19 pandemic and in part because […]
One of the most significant Medicaid managed care developments in 2021 happened on December 29, when CMS approved federal funding and waivers for California’s reform initiative, Advancing Innovation in Medi-Cal (CalAIM). The approval involved two sets of waivers, one operating under section 1115 of the Social Security Act, the other under section 1915(b)(4). For good […]
The world of Section 1115 Medicaid waivers can be mysterious and weedy, arcane and annoying, boring and, at times, dramatic. And in recent years, the use of Section 1115 authority by the Trump Administration stretched all previously known boundaries and wound up in court on multiple occasions – most famously in the Arkansas work requirements […]
In 2020, Georgia submitted a waiver under Section 1332 of the Affordable Care Act (ACA) to allow the state to exit HealthCare.gov; the Trump Administration approved the request in November of last year. Under this proposal, the 500,000 Georgians who use the federal marketplace every year to enroll in private health plans and Medicaid would […]
State seeks to become the first to provide continuous coverage to all children enrolled in Medicaid until age six while continuing to restrict children’s access to health care by continuing to deny them the EPSDT benefit package provided to children in all other states. After months of engaging stakeholders, Oregon has posted its draft […]
We recently submitted public comments on Florida’s amendment to its Section 1115 waiver which has a medley of requests for the federal government to consider. On the plus side, the state is seeking to extend postpartum coverage from 60 days to 12 months (although it is unclear why they need a waiver). But on the […]
