Medicaid
has transformed health care for low-income families and individuals, especially children, pregnant mothers, parents and children with disabilities and special health care needs.
Federal Funding Cuts to Medicaid May Trigger Automatic Loss of Health Coverage for Millions of Residents of Certain States
Despite virtually no discussion of Medicaid during the election, Medicaid is facing proposals for significant reductions in federal funding. My colleague Edwin Park has already detailed some of the discussion around these cuts – which are being considered in service of facilitating an extension of tax breaks, the majority of which would go to the […]
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 […]
Congressional Republican Leaders Start to Show Their Hand: Draconian Medicaid Cuts on the Agenda for Next Year
I have been warning for months that Medicaid would be on the chopping block if there is a second term of the Trump Administration and if Congressional Republicans win House and Senate majorities in 2025. That is because the Project 2025 blueprint, the fiscal year 2025 Republican Study Committee budget plan, and the fiscal year […]
CMS Approves Five More States to Adopt Medicaid Multi-Year Continuous Coverage for Young Children As Threats to Coverage Loom
Yesterday, CMS approved a set of another five state 1115 waiver demonstration applications to adopt multi-year continuous eligibility for children in Medicaid. Four states (Hawaii, Minnesota, New York and Pennsylvania) were approved to adopt continuous eligibility for children in Medicaid from birth to age 6; Colorado was approved to implement for children up to age […]
Transparency in Medicaid Managed Care: CMS Posts Annual MLR Reports
On November 1, CMS posted on its website Medical Loss Ratios (MLRs) for individual Medicaid managed care organizations (MCOs) in 2018, 2019, and 2020. These data come from the MLR Summary Reports that states are required to submit to CMS. This CMS action follows the posting on July 15 of the first tranche of Managed […]
Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q3 2024
Another quarter, another round of earnings reports from the “Big Five.” The story of Q3 continues the basic narrative of Q1 and Q2. For all but one of the companies that dominate the Medicaid managed care market, net Medicaid enrollment continued to decline, driven primarily by the PHE unwinding. There is one new wrinkle, however. […]