Medicaid
-
Medicaid’s Pandemic-Era Continuous Coverage Protections Helped Reduce Number of Uninsured Children
Download Report PDF Introduction Data from the U.S. Census Bureau’s American Community Survey (ACS) for 2022 finds that the number of uninsured children continued to decline over the pandemic period – most likely as a consequence of the continuous coverage protection in Medicaid put in place by one of the first COVID-19 rescue packages, the…
-
Bipartisan Senate Finance Committee Legislation Includes Enhanced Medicaid Pharmacy Pricing Survey Provision
On November 8, 2023, on an unanimous 26-0 vote, the Senate Finance Committee approved the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act. The bill includes a number of Medicare and Medicaid provisions but also incorporates two sound Medicaid drug pricing provisions related to “spread pricing” in Medicaid managed care and to Medicaid pharmacy…
-
Can MMRCs Do More to Inform State Medicaid Maternal Health Efforts?
As rates of maternal mortality have risen in the United States, maternal mortality review committees (MMRCs) have been an important tool to understand why these maternal deaths occur. State MMRCs consist of multidisciplinary representatives to review deaths that occur during or within a year of pregnancy. In our recent 12-state scan of Medicaid MCO performance…
-
CCF’s Unwinding and Enrollment Trackers Explained
Since Medicaid unwinding of the continuous coverage requirement has begun, net child Medicaid enrollment has fallen by more than two million and overall net Medicaid enrollment has declined by more than five million. We have received some questions about how we calculate these net enrollment figures as well as the basis of other unwinding data…
-
Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q3 2023
The “Big Five” Medicaid managed care companies—Centene, CVS Health (Aetna), Elevance Health (formerly Anthem), Molina Healthcare, and UnitedHealth Group—have reported their Medicaid enrollment for the quarter ending September 30. The downward trend that began in Q2 continued for all of the companies except Molina, which experienced a small net increase (+16,000). Centene reported the largest…
-
Webinar: Medicaid Managed Care Organizations and Maternal Health
View Webinar Transcript Download the Presentation Slides
-
New Federal Rules Seek To Strengthen Mental Health Parity
By Maanasa Kona, Assistant Research Professor at the Center on Health Insurance Reforms On July 25, 2023, the Departments of Labor, Health and Human Services, and the Treasury (the tri-agencies) proposed a new rule to strengthen the enforcement of the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and ensure that patients can access mental health and substance…
-
Marketplace Enrollment Rises Again in July But Still Represents Only Small Share of Those Losing Medicaid Coverage During Unwinding
As readers of Say Ahhh! know, I have been tracking monthly data (here, here, and here) from the Centers for Medicare and Medicaid Services (CMS) on the number of people who were either previously enrolled in Medicaid or had experienced a denial or termination who then selected a marketplace plan. CMS has just issued new…
-
Updated List of Flexibilities Highlight Variety of Approaches States Are Taking to Promote Continuity of Coverage During the Unwinding
To meet the unprecedented moment of the unwinding of the Medicaid continuous coverage protection, states have implemented a range of innovative policies to make the renewal process smoother for enrollees as well as state eligibility workers. One tool that states have increasingly used is Section 1902(e)(14)(A) waivers, or “e14s,” which we have written about previously…
-
Response to American Academy of Pediatrics New Policy Statement
The following is a statement by Joan Alker, Executive Director of the Center for Children and Families at Georgetown University’s McCourt School of Public Policy in response to American Academy of Pediatrics New Policy Statement: “I applaud the new policy statement by the American Academy of Pediatrics outlining the direction that Medicaid and the Children’s Health Insurance…
-
Medicaid Managed Care: Transparency of Performance on Maternal Health
Our nation is in the midst of an ongoing maternal health crisis, one that particularly affects Black women. The causes are complex, the need to address them is urgent, and there is no single solution. One of many potential solutions that has not received enough attention is Medicaid managed care. Medicaid, the nation’s largest health…
-
Medicaid Managed Care, Maternal Mortality Review Committees, and Maternal Health: A 12-State Scan
Download the Full Report Introduction The United States is in the midst of an ongoing maternal mortality crisis and Medicaid, the health insurer for low-income Americans, has an important role to play in addressing it. Medicaid is the nation’s single largest maternity care insurer, paying for more than 40% of all births on average across all states,…
-
CMS Makes the Right Call on Utah’s Medicaid Waiver: Where Do Things Stand on Postpartum Coverage?
In a little-noticed but important action, CMS recently notified the Utah Medicaid agency that it should proceed with extending postpartum coverage from 60 days to 12 months under the state plan amendment (SPA) option rather than continuing to pursue its Section 1115 waiver request. At first blush, this seems like a distinction only the most…
-
How Did We Get Here? A Recent Legislative History of Medicaid Managed Care
Just over 25 years ago, Congress enacted a major change in federal policy on Medicaid managed care. It eliminated the 75/25 rule—the requirement that no more than 75 percent of the enrollees in a Medicaid managed care organization (MCO) could be Medicaid or Medicare beneficiaries. The logic of the rule was that if an MCO…
-
Black Maternal & Mental Health Summit Highlights the Urgency for Policy and Practice Change
In July, I had the chance to attend the Black Maternal & Mental Health Summit hosted by the Shades of Blue Project. Founder Kay Matthews established Shades of Blue in 2013 after the loss of her stillborn daughter. With worsening maternal morbidity rates in the United States, Kay has turned to advocacy as a way…
-
Unwinding Data Recap: What Do We Know So Far?
Last Friday marked the end of the month, which meant the release of new unwinding data from CMS. This time, though, CMS not only published data on renewal outcomes for June, but also posted preliminary outcome data for July, cutting the time lag to two months. As a result, there is now unwinding data available…
-
CMS Releases Guidance on 12-Month Continuous Eligibility for Children
CMS has released long awaited guidance to states on implementing 12-month continuous eligibility (CE) for all children in Medicaid and the Children’s Insurance Program (CHIP) under the age of 19 as enacted by Congress in the Consolidated Appropriations Act. As of January 2023, 26 states cover some or all children in Medicaid for a full…
-
HHS Takes Action on Maternal Mental Health Initiatives, Requests Input on Medicaid/CHIP Parity Compliance
Last week, the Administration announced a number of actions related to mental health with a focus on maternal health as well as parity in Medicaid and the Children’s Health Insurance Program (CHIP). Here’s a readout of the latest actions: Maternal Health Funding: HHS announced awards of more than $103 million to support and expand access…
-
AAP and CCF Release 2023 State Snapshots on the Importance of Medicaid for Children’s Coverage
Starting back in 2017 we created state snapshots with our colleagues at the American Academy of Pediatrics that show who Medicaid covers in each state, with a particular emphasis on Medicaid’s role in covering children. After a hiatus during the pandemic, we’ve updated the easy-to-understand 2-pagers with all the latest data on how Medicaid helps…
-
State Medicaid and CHIP Snapshots, 2023
The Georgetown University Center for Children and Families (CCF) and the American Academy of Pediatrics (AAP) created factsheets underscoring the importance of Medicaid in providing coverage for children in all 50 states and the District of Columbia. Sources available here. Previous snapshots can be found here (2019), here (2018) and here (2017). Check out more interactive…
