Medicaid
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Expanding Options to Identify Renewal Dates Could Help Minimize Procedural Disenrollments
We’re only four months into the Medicaid unwinding and the scale of coverage loss for procedural reasons is already staggering. An estimated 1.6 million individuals have lost coverage, with 71 percent terminated for procedural reasons. Stories are trickling in about why these procedural disenrollments may be occurring, including families not getting notices in the mail.…
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CCF Comments on Proposed Managed Care Rule
The Georgetown University Center for Children and Families submitted the following comments to HHS regarding the proposed managed care rule (“Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality; Proposed Rule-CMS-2439-P”). Comments on Managed Care Rule
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CCF Comments on Proposed Access Rule (CMS-2442-P – “Medicaid Program; Ensuring Access to Medicaid Services”)
The Georgetown University Center for Children and Families submitted the following comments to HHS regarding the proposed access rule (“Medicaid Program; Ensuring Access to Medicaid Services – CMS-2442-P”). Comments on Proposed Access Rule
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Georgetown CCF Analysis Finds Georgia’s Pathways to Coverage Program Would Cost More to Cover Fewer People
This week, we released a new analysis, written by Allexa Gardner, Joan Alker and Leo Cuello, that finds Georgia’s limited Medicaid expansion program, known as “Pathways,” is fiscally foolish and sets up a structure that discriminates against parents. Enrollment for Pathways begins on July 1st with coverage being at a later date likely September 1.…
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An Analysis of Georgia’s Section 1115 Medicaid Pathways to Coverage Program
Download Full Report In July 2023, Georgia will begin enrollment into its new Medicaid Pathways to Coverage (“Pathways”) program, with coverage expected to begin in September 2023. The program would offer coverage to a subset of low-income adults who meet a work reporting requirement and, depending on their income, pay a monthly premium. Georgia will…
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Comments on Utah Medicaid Reform 1115 Demonstration Amendment Request for Postpartum Coverage Extension
The Georgetown University Center for Children and Families in conjunction with the Center on Budget and Policy Priorities submitted the following comments to HHS regarding the proposed postpartum coverage extension in Utah. Utah Postpartum Coverage Extension Comments
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House Republican Study Committee Budget Plan Again Includes Draconian Medicaid Cuts
On June 14, 2023, the Republican Study Committee (RSC), whose members comprise more than three-quarters of the House Republican caucus, announced its fiscal year 2024 budget plan. The budget plan proposes to cut total federal Medicaid, CHIP and Affordable Care Act marketplace subsidy spending by more than half over the next decade, relative to current…
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Research Update: What Does Persistent Poverty Mean for Medicaid?
A recent report from the U.S. Census Bureau has identified 341 counties nationwide that are in persistent poverty, which is defined as having a poverty rate of 20% or higher during the past 30 years from 1989 through the 2015-2019 data period (for context, the national poverty rate in 2015-2019 was 13.4%). While persistent poverty…
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Medicaid Unwinding: Why Retroactive Coverage is not the Answer to Procedural Disenrollments as Some Claim
As readers of SayAhhh! know, we are closely monitoring the impact of Medicaid unwinding. We’ve been worried about inappropriate and large coverage losses for children and families for quite some time now – and as states get started and are reporting large numbers of procedural terminations our fears have not been allayed. There are those…
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Unpacking Unwinding Data: What’s with All the Different Numbers?
As of June 1st, most states have started terminating Medicaid coverage for children, low-income families, and others for non-eligibility, procedural reasons. We are trying to get our hands on as much data as we can to get a sense of the outcomes of Medicaid renewals and what the unwinding process looks like across states. Transparency…
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Alabama’s Women Need Medicaid Expansion: One in Six Women Aged 18-44 Lack Health Coverage and Face Many Barriers to Good Health
Report by: Maggie Clark, Georgetown University CCF, & Debbie Smith, Alabama Arise Download Full Report Introduction Alabama mothers face many barriers to good health. The state faces high maternal and infant mortality rates, high rates of uninsurance among women of childbearing age, and worsening access to maternity care providers. These problems are compounded by Alabama’s…
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How Are States Addressing Mental Health Needs of Infants and Toddlers in Medicaid Policy? New 50-state Report
As lawmakers scramble to address the nation’s worsening mental health crisis among children, few of these efforts have focused on the unique developmental needs of children before they reach kindergarten. It’s hard to imagine an infant or toddler experiencing mental health challenges, but as ZERO TO THREE shows,10-16% of young children experience mental health conditions,…
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CMS Asks States and Stakeholders to Lean In and Help Respond to Mounting Concerns About Eligible Children, New Moms and Others Losing Medicaid During Unwinding
As outcomes data has emerged from states getting an early start on resuming Medicaid renewals, there are mounting concerns about eligible children, new moms, and others losing coverage due to procedural disenrollments. In response, CMS released additional information on the unwinding, including a letter from HHS Secretary Becerra to governors urging them to adopt additional…
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CCF Comments to Medicaid Drug Rebate Program Proposed Rule
Under the highly effective Medicaid Drug Rebate Program (MDRP), drug manufacturers must provide substantial rebates to state Medicaid programs in order for their prescription drugs to be covered by Medicaid. Because of the MDRP, the Congressional Budget Office has found that Medicaid obtains the lowest prescription drug prices, net of rebates and discounts, among other…
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Medicaid Policies to Help Young Children Access Infant-Early Childhood Mental Health Services: Results from a 50-State Survey
By: Sheila Smith, Maribel R. Granja, Elisabeth Wright Burak, Kay Johnson, and Daniel Ferguson; Representing the National Center for Children in Poverty, Georgetown University Center for Children and Families, and Johnson Policy Consulting Full report available here. INTRODUCTION Young children covered by Medicaid are growing up in low-income households and are more likely to experience…
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Proposed Expansion of Self-funding for Small Employers Would Roll Back Affordable Care Act Protections, Pre-empt State Insurance Oversight
By Georgetown University McCourt School of Public Policy Center on Health Insurance Reforms The U.S. House of Representatives Education & Workforce Committee is poised to advance a bill, H.R. 2813, that would encourage the expansion of self-funded employer-based insurance exempt from key Affordable Care Act (ACA) protections and preempt states’ efforts to stabilize premiums for small…
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A Closer Look at the Transparency Provisions of CMS’s Proposed Medicaid Access and Managed Care Rules
Editor’s Note: Since this post was published, CCF submitted formal comments on both the Medicaid Access and Managed Care proposed rules. Transparency has long been underrated as a way of improving access to care in Medicaid. This may be about to change. Two proposed rules that CMS published on May 3 use transparency—making information about…
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Medicaid Managed Care: A New Group Arrives on the CMCS Block
There’s a new box on the Center for Medicaid & CHIP Services (CMCS) organization chart! It’s the Managed Care Group, one of (now) eight Groups within CMCS that manage the Medicaid program for the federal government. You’re probably thinking, “So what? A federal bureaucracy gets a new Group. What difference will that make for children…
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New CBO Estimates of the Impact of Unwinding on Medicaid Enrollment, Uninsured
On May 24, 2023, the Congressional Budget Office issued new health coverage estimates for people under age 65 through a Health Affairs article and an updated May 2023 “Federal Subsidies for Health Insurance Coverage” baseline. The estimates show the expected adverse impact of unwinding of the Medicaid continuous coverage protection in substantially reducing Medicaid enrollment…
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Preventing the “Unwelcome Mat” Effect: Ensuring Eligible Kids Remain Covered
One of our biggest concerns heading into the unwinding has been children experiencing gaps in health care coverage, especially as a result of losing coverage despite remaining eligible. As my colleague Elisabeth Wright Burak detailed a few weeks ago, these fears are already coming true in at least one state. Later this week, most states…
