CHIP
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2025 Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies Survey Released by KFF and CCF
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…
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Medicaid and CHIP Rules on Chopping Block
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…
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Medicaid Managed Care: Transparency for Young Children in 12 States
Regular Say Ahhh! readers know that most children covered by Medicaid in most states received their coverage through private insurance companies, or managed care organizations (MCOs). We believe that publicly-available data on Medicaid managed care performance is key to fully understanding how well Medicaid MCOs are working for children. Consistent, MCO-level data helps identify gaps…
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The Budget Resolution and Reconciliation Process Explained
In early 2021, we wrote about the basic rules for passing legislation in the House versus the Senate and how the budget reconciliation process allows certain legislation to move forward with approval from a simple majority of Senators rather than be subject to the filibuster and the usual three-fifths or 60-vote threshold. Given recent reports…
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Webinar: Federal Medicaid Cuts & What’s at Stake for State Budgets and Families
The Georgetown University Center for Children and Families (CCF) held a special virtual session of our new Child Medicaid Policy Institute (CMPI) on Tuesday, December 17 at 2 pm ET. What: CMPI seeks to educate health advocates, providers, other stakeholders, and policymakers on the fundamentals of the Medicaid program and its importance for children, families, and…
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Are Children Receiving the Full Protection of Medicaid’s Pediatric Benefit Package?
Medicaid covers over 30 million children, or about 40 percent of all children. Medicaid covers disproportionately large shares of low-income children, children of color, and children with special health care needs. Medicaid law and policy necessarily impact children, oftentimes children who would be uninsured or underinsured without it. Children with Medicaid coverage are entitled to…
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Medicaid/CHIP Coverage by Congressional District, 2023
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas…
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How Covering Adults Through Medicaid Expansion Helps Children
Opponents of Medicaid expansion often argue that enacting expansion will harm “traditional” Medicaid beneficiaries including children. This brief cites studies finding the opposite is true. Studies have documented multiple positive effects for children of expanding coverage for parents and other adults including higher child coverage rates, lower rates of infant mortality and higher birthweights, and…
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CMS Highlights EPSDT Policies and Strategies for Improving Care for Children with Behavioral Health Needs
As discussed in our blog series on the CMS’s new EPSDT guidance, the 57 page state health official letter lays out a number of policies and strategies to help states meet their EPSDT requirements under Medicaid – including care for children with behavioral health needs. As you may recall, in 2022, CMS released an informational…
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New EPSDT Guidance Reinforces Key Medicaid Prior Authorization Protections for Children – And We’d Like to See Even More
Everyone under the age of twenty-one in Medicaid should have access to health care services they need thanks to Medicaid’s Early and Periodic Diagnostic Screening and Treatment (EPSDT) requirement. In short, EPSDT requires children to get regular screenings and treatment when necessary. And this isn’t a vague hope – it’s the law. However, in at…
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CMS EPSDT Guidance Blog Series
CMS released a state health official (SHO) letter outlining the requirements states and managed care plans must meet under Medicaid’s pediatric benefit, known as Early and Periodic Screening, Diagnostic and Treatment or EPSDT. The EPSDT SHO also describes some strategies and identifies best practices currently in use by states to meet the various requirements. This…
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Urban Institute Report on Parent Health Coverage Finds Mothers of Young Children Showed Greatest Gains
Last month, the Urban Institute released a report detailing uninsurance rates between 2019 and 2022 for families with young children (under age 3). The report revealed significant drops—for the children, for fathers, and most significantly, for mothers. There were multiple factors contributing to these rises in coverage rates—pandemic-era continuous enrollment policies such as the Families…
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No Child Should Be Uninsured: New Bill Would Cut Medicaid Red Tape and Reduce Harmful Gaps in Coverage
At Georgetown CCF we have been thinking about a day when no child in the United States is uninsured since our inception 19 years ago. Substantial progress has been made over the past two decades with some ups and downs along the way. However, as the recent Medicaid unwinding made abundantly clear, this day will…
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New Report Explores Insights from Medicaid Unwinding on How to Protect Children’s Coverage
The Urban Institute and Georgetown CCF have released a new report highlighting ways to improve the Medicaid/CHIP redetermination process for children emanating from key lessons learned during the unwinding of the Medicaid continuous coverage protection. These insights are based on interviews of representatives in 8 state Medicaid agencies, offering a unique perspective directly from the…
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Massachusetts Governor Signs a Maternal Health Bill Expanding Access to Midwifery, Birth Centers and Doulas
On August 23rd, Governor Maura Healy of Massachusetts signed an act promoting access to midwifery care and out-of-hospital birth options into law. This comprehensive maternal health bill focused on expanding midwifery coverage to include certified professional midwives (CPMs), birth centers, doulas, and screening and treatment options for postpartum depression. MassHealth is Massachusetts Medicaid and CHIP…
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New Federal Funding Opportunity for State Medicaid and CHIP Programs to Support Continuity of Care for Justice-Involved Individuals
Last week, many in the Medicaid and CHIP community were focused on CMS’s announcement of guidance to states on Medicaid EPSDT requirements (and for good reason). However, we also wanted to make sure folks saw the new notice of funding opportunity for planning grants to state Medicaid and CHIP agencies to develop operational capabilities to…
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Medicaid/CHIP Mental Health Parity: Latest Federal Actions Explained
Last week, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury released their much-anticipated final rules to strengthen the enforcement of the federal Mental Health Parity and Addiction Equity Act (MHPAEA). As highlighted by the DOL, the final rules, among other provisions, make clear that group health plans and health insurance…
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State Momentum, New Tools, Implementation Questions on Multi-Year Continuous Eligibility
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…
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Webinar: Using Section 1115 Demonstrations to Support Health-Related Social Needs for Prenatal to 3 Population
Over the past few years, states have been increasingly seeking to use Medicaid section 1115 demonstrations to cover health-related social needs (HRSN) services and supports. While many states are including pregnant and postpartum individuals and their children as eligible populations to receive these benefits, not all individuals within the pregnancy and postpartum eligibility group will…
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CMS Gives Options to States with “Unusual Circumstances” to Extend Unwinding Renewals, Redistributing Renewals, and Deal with Pending Renewals
CMS has released new guidance for states that are not yet done with the unwinding. Due to the unprecedented nature of the unwinding – exacerbated by workforce challenges and resulting in an uneven and unsustainable renewal volume in many states – CMS concludes that the unwinding constitutes an administrative emergency that justifies exceptions to the…
