Medicaid
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CCF Comments on Processes for Assessing Compliance with Mental Health Parity and Addiction Equity in Medicaid and CHIP
The Georgetown University Center for Children and Families submitted the following comments to CMS regarding the proposed processes for assessing compliance with mental health parity and addiction equity in Medicaid and CHIP. Read the Comments
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CMS Releases New Unwinding-Related Renewal Resources for Health Care Settings
CMS recently released a toolkit for clinical offices and health care settings with patient-centered messaging regarding the unwinding of the Medicaid continuous enrollment requirement. The toolkit includes helpful information on how health care providers can share information on Medicaid and CHIP renewals with patients. The toolkit starts with suggestions on what various staff members within…
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Florida’s Rolling Out a New Medicaid/SNAP Portal Next Week – Throwing Gas on the Unwinding Fire
With little advance notice to the community, the state of Florida announced in mid-November that it was moving next week (December 5th) to a new portal for eligibility for Medicaid, SNAP, child care and TANF; and that every person/household in the state accessing those benefits will need to create a new account. Every person create…
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Biden Administration Says No to Premiums in Medicaid Again – This Time in Wisconsin
We’re getting to the end of the year and a seasonal tradition for Medicaid Section 1115 waiver watchers is observing an uptick in waiver activity by the federal Centers for Medicare and Medicaid Services (CMS). Last Friday, CMS issued a temporary one-year extension (in place until December 31, 2024) for Wisconsin’s BadgerCare Section 1115 demonstration…
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North Carolina and Hawaii Make 10: States Advancing Medicaid/CHIP Multi-Year Continuous Eligibility for Young Children
It’s hard to keep up with the rapid progress in the number of states seeking federal approval to adopt multi-year continuous coverage for children covered by Medicaid and the Children’s Health Insurance Program (CHIP). Since we last took stock, North Carolina and Hawaii have proposed 1115 waivers to adopt continuous eligibility for children from birth…
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New CBO Study Explores the Long-Term Fiscal Benefits of Medicaid Coverage in Childhood
There is a large and growing body of research demonstrating the long-term benefits of Medicaid coverage during childhood and during pregnancy. This includes better health and lower incidence of disability in adulthood, higher educational attainment, and greater earnings and intergenerational mobility. Now, in a new working paper, the Congressional Budget Office (CBO) has conducted an…
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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…
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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…
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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…
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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…
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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…
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Webinar: Medicaid Managed Care Organizations and Maternal Health
View Webinar Transcript Download the Presentation Slides
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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…
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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…
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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…
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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…
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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…
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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,…
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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…
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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…
