Medicaid
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Breaking News: CMS Reveals States Are Incorrectly Processing Ex Parte Renewals; Kids Are Most at Risk
Today, CMS released troubling information. Based on the agency’s monitoring of the unwinding of the COVID-related Medicaid continuous enrollment requirement, CMS found that many states are conducting ex parte renewals incorrectly. As a result, many children and other enrollees are or could soon be losing their Medicaid coverage when the state had information that they…
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Statement by Joan Alker on Biden Administration Medicaid Ex Parte Announcement
The following is a statement by Joan Alker, executive director of the Georgetown University Center for Children and Families in response to Biden Administration letter to states requiring Medicaid ex parte renewal fixes and reinstatement of children and others impacted. “Children are especially at risk during the current process of checking eligibility for everyone covered…
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Medicaid Coverage for Pregnant Women and Their Young Children Linked to Health of the Next Generation
As we see increasing numbers of pregnant women and newborns being disenrolled from Medicaid, a new study adds to evidence of long-term benefits of Medicaid investments– this time for the grandchildren and children of pregnant women and their newborns. For many years, CCF has highlighted the growing research on the long-term health and educational impacts…
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“Deemed Newborns:” Collateral Damage in the PHE Unwinding
This blog is about the babies on the bus. You know, the ones who go “Wah-Wah-Wah” all around the town. It seems that, in the course of the PHE unwinding, some of them are getting thrown under the bus. As my colleague Elisabeth Wright Burak recently reported, Arkansas disenrolled 3,300 newborns from Medicaid in April;…
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Transitional Medical Assistance (TMA): Extending Medicaid Coverage for Working Parents
Terminations of Medicaid eligibility are much in the news these days. While the large majority of disenrollments to date have been for procedural reasons, there are individuals who have been disenrolled after a state Medicaid agency has actually made a determination that the individual is ineligible. In these situations, the agency is required to determine…
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New Brief: Where Things Stand on the Medicaid and CHIP Provisions of the Bipartisan Safer Communities Act
Medicaid (alongside the Children’s Health Insurance Program) covers more than half of all children in the U.S. and serves as the single largest payer of behavioral health services. Yet, timely access to mental health services remains elusive for many children and families. In June 2022, President Biden signed into law the Bipartisan Safer Communities Act…
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Why Are So Many Kids Losing Medicaid Coverage?
At the end of the COVID pandemic, more than half (54%) of the nation’s children were covered by Medicaid or CHIP; the vast majority by Medicaid. So, the lifting of the pandemic-related Medicaid continuous enrollment protection this spring is a really big deal, putting low-income children at risk of losing access to health care and/or…
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Medicaid Provision of Draft House Drug Shortages Bill Raises Concerns
This year, there has been renewed focus in Congress on how to address the ongoing problem of drug shortages, especially with cancer patients now facing severe shortages of widely used generic chemotherapy drugs. On July 28, 2023, House Energy and Commerce Committee Chair Cathy McMorris Rodgers unveiled a draft bill intended to address the “root…
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The Biden Administration CMS Unwinds the Tennessee “Block Grant”
Two and a half years ago, on January 8, 2021, with considerable fanfare, the Trump administration CMS announced the approval of a Medicaid “aggregate cap waiver” for Tennessee. The Governor was more forthcoming, trumpeting the state’s receipt of a “block grant waiver.” You say “aggregate cap,” I say “block grant,” let’s call the whole thing…
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Medicaid’s Role in Rural Areas Has Grown: Families Have Much at Stake in the Unwinding
In 2017 we published our first report examining the role of Medicaid in rural areas. We’ve updated the data a few times and our newest look is based on Medicaid coverage in 2020-2021. The data underscores the outsize importance of Medicaid as a source of health insurance coverage in rural areas and small towns –…
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Community Health Workers & Medicaid: Advancing Health Equity Depends on State Implementation
As National Community Health Worker Awareness Week approaches at the end of August, we want to take stock of the advances in Medicaid’s role in financing community health worker (CHW) services and the road ahead. CHWs have a long history of supporting community public health by engaging individuals in communities that the traditional health system…
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Senate Finance Committee PBM Legislation Includes Sound Medicaid Drug Pricing Provisions
On July 26, 2023, on a 26-1 bipartisan vote, the Senate Finance Committee approved the Modernizing and Ensuring PBM Accountability Act. The bill includes a number of Medicare provisions related to pharmacy benefit managers (PBMs) and pharmacies but also includes two sound Medicaid provisions related to “spread pricing” in Medicaid managed care and to Medicaid…
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2023 Medicaid and CHIP Snapshot Data Sources
Names of Medicaid and CHIP Programs State-specific names for Medicaid and CHIP programs (as of September 2023) can be found at HealthCare.gov – Medicaid and CHIP program names in your state. Medicaid/CHIP Enrollees The share of Medicaid/CHIP enrollees in the child, adult, disability, and senior eligibility groups calculated from MACStats: Medicaid and CHIP Data Book,…
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Limited Child Medicaid Unwinding Data Begins to Paint Bleak Picture, Highlights Need for More Transparency
As we continue to unpack the first round of unwinding data released by CMS a few weeks ago, it remains disappointing that there is not more data on children. As readers of SayAhhh! know, the stakes for children are very high with over half of the children in the country insured through Medicaid, and they…
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Understanding the Medicaid Unwinding Data: Marketplace Enrollment
On July 28, 2023, the Centers for Medicare and Medicaid Services (CMS) finally released renewal outcome data from the first two months — March and April 2023 — of unwinding of the Medicaid continuous coverage protection. The data is largely consistent with data that we have already posted in our tracking of state administrative unwinding…
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Data shows kids greatly impacted by KanCare redeterminations
By Heather Braum, Kansas Action for Children Kansas released the second set of data for how the year-long KanCare unwinding process is going, with data available through June 30, 2023, and has now broken out the data into age ranges and by county for those who had not returned a renewal form in April or May. Since…
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First Batch of CMS Unwinding Data Includes Key Call Center Statistics
Last Friday, CMS released the first round of long-anticipated Medicaid unwinding data. The main focus has been on the renewal outcome data submitted in state monthly reports, which unfortunately was only available for the 18 states who began terminating coverage as of March 31 or in April 2023 due to a lengthy lag – and…
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Medicaid Managed Care: Denials of Prior Authorization for Services
Kudos to the OIG! That would be the Office of the Inspector General of the Department of Health and Human Services. Although OIG is better known for its fraud-fighting persona, it also has a broader mission of making government programs work better. And with last month’s report, “High Rates of Prior Authorization Denials by Some…
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Administration Releases Medicaid and CHIP Mental Health and SUD Action Plan, Parity Initiatives
In another round of mental health-related announcements, this week, the Centers for Medicare & Medicaid Services (CMS) released a Medicaid and CHIP Mental Health and Substance Use Disorder Action Plan alongside Administration announcements focused on mental health parity. The seventeen page Mental Health and Substance Use Disorder Action Plan provides an overview of Medicaid and…
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Transparency, Trackers, and Toolkits: Updates on CCF Unwinding Materials
By Ella Mathews and Shreya Kalra As Unwinding Wednesday readers know, our 50 State Unwinding Tracker is updated regularly as we monitor new information, specifically new unwinding data, provided by states. The tracker has evolved since we released it almost a year ago – both in the number of states publicly providing unwinding information and…
