Medicaid
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Medicaid Funding for Home Visiting: Time to Scale What Works for Young Children and Families
As more states adopt Medicaid’s postpartum extension, making health coverage work for postpartum people and their newborns requires dedicated attention by states on the best ways to ensure mom and child get the right care at the right time. One popular, evidence-based intervention for young families is home visiting. The approach typically includes some combination…
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New CMS Proposed Rule Could Help State Medicaid Programs Negotiate Greater Supplemental Rebates for Certain High-Cost Drugs
On May 23, 2023, the Centers for Medicare and Medicaid Services announced a new proposed rule related to the Medicaid Drug Rebate Program (MDRP) and other Medicaid drug pricing, reimbursement and data collection issues. While much of the proposed rule focuses on regulatory changes conforming to legislation affecting the MDRP enacted in recent years as…
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Maternal Mental Health Month Shines Light on Need for Policy Solutions
May is a month for moms: we celebrate Mother’s Day, it’s maternal mental health awareness month, and Congressional leaders chose May to reintroduce the Black Maternal Health Momnibus, a group of a dozen bills designed to address all facets of the Black maternal mortality crisis. Giving birth and taking care of a young child is…
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More Outreach to Families Needed During the Unwinding; Some States Are Stepping Up Their Game
KFF released new survey data that finds two-thirds of Medicaid enrollees are unprepared for the renewal process as states begin the process of “unwinding” the Medicaid continuous coverage requirement that was lifted by Congress on March 31. The KFF survey includes more interesting data that reveals that large majorities across demographic groups are not aware…
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A Closer Look at the Medical Loss Ratio (MLR) Provisions of CMS’s Proposed Medicaid Managed Care Rule
Editor’s Note: Since this post was published, CCF submitted formal comments on the Managed Care proposed rule. Earlier this month, CMS proposed changes to regulations that govern the operation of Medicaid managed care in 41 states. The main purpose of the proposals is to improve access to care (by, among other things, beefing up network adequacy…
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New Interactive Maps Show Importance of Medicaid Coverage to Children and Families in Rural Counties and Small Towns
Georgetown University Center for Children and Families, with data from the University of North Carolina’s Sheps Rural Health Research Center, has examined the role Medicaid plays in health insurance coverage in rural areas, including how state Medicaid expansions helped reduce uninsurance, as part of our rural health policy project launched in 2017. Now we have…
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Research Update: It’s Simple—Medicaid Helps People Work
My colleagues have been analyzing the highly damaging Medicaid work reporting requirement provisions of the House-passed debt ceiling bill crafted by Speaker McCarthy, including how it would likely harm people with disabilities and parents. There is an overwhelming stack of evidence showing that work requirements are a terrible idea: they don’t actually improve employment rates,…
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It’s Here! An Introduction to the Much-Anticipated Updated School-Based Medicaid Services and Administrative Claiming Guide
May is Mental Health Awareness Month, and last week’s news takes this month to heart with the release of the much-awaited Comprehensive Guide to Medicaid Services and Administrative Claiming by the Centers for Medicare & Medicaid Services (CMS) in consultation with the US Department of Education (ED). The first comprehensive update in two decades, CMS’s…
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Medicaid Managed Care: Results for the Big Five in PHE Q13
The earnings reports for the “Big Five” for the quarter ending March 31—known here as PHE Q13—are in. The “Big Five”—CVSHealth (Aetna), Centene, Elevance Health (formerly Anthem), Molina Healthcare, and United Health Group—need no introduction, either to state Medicaid agencies or investors. Together, they had 44.2 million Medicaid enrollees as of March 31. If children…
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How Many Children Just Lost Coverage in Florida?
We just received a copy of Florida’s report to CMS on its first month of “unwinding” the Medicaid continuous coverage provisions for April and the data is alarming. Of the 461,322 people whose eligibility was checked, more than half — 54% or 249,427 people — were terminated. Most of those terminated (82%) had their cases…
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Arkansas Unwinding Numbers Show What’s at Stake for Very Young Children
Georgetown University Center for Children and Families (CCF) has sounded the alarm bells for more than a year warning that without strong state leadership and careful attention, millions of children, parents, disabled people and others eligible for Medicaid could be erroneously disenrolled for procedural reasons. Children are far more likely to lose Medicaid and CHIP…
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Update: North Carolina Passed Medicaid Expansion – Here’s How Politicians Justified Change of Heart
In March this year, the North Carolina legislature passed Medicaid expansion with bipartisan support, becoming the first state to pass expansion legislatively since Virginia in 2018. In an interesting turn of events, many House and Senate Republicans in North Carolina, who for years staunchly opposed expanding Medicaid, changed their positions leading up to the bill’s…
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Low-Income Parents at Significant Risk Under the House-Passed Medicaid Work Reporting Requirements in Debt Ceiling Bill
We’ve been closely reading Section 321 of the House-passed debt ceiling bill which would establish a pernicious new maze of red tape to trip people up and cause them to lose Medicaid coverage. While posing as a “work requirement”, this is really a plan to make people jump through more hoops in order to keep…
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More States Extend Postpartum Medicaid Coverage as Three States Fall Behind
Just this month, Missouri and Alaska joined the growing list of states where their legislatures approved extending postpartum Medicaid coverage from 60 days to 12 months, following Mississippi, Wyoming, Montana, South Dakota, and other states that have acted this year. CMS is expected to approve the extensions after the states submit their state plan amendment…
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A Closer Look at the Network Adequacy Provisions of CMS’s Proposed Medicaid Managed Care Rule
Editor’s Note: Since this post was published, CCF submitted formal comments on the Managed Care proposed rule. Last week my colleague Kelly Whitener promised readers of the Say Ahhh! Blog a series of blogs on the proposed rules that CMS has published to improve access to care in Medicaid and CHIP. Promises made, promises kept. …
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CMS Proposes to Revamp Medicaid Advisory Committees
Editor’s Note: Since this post was published, CCF submitted formal comments on both the Medicaid Access and Managed Care proposed rules. Just a few months ago, we urged Medicaid advocates to consider leveraging their state Medicaid advisory committees to help improve their Medicaid programs. But now we’re happy to report that exciting changes may be…
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A Closer Look at Medicaid Call Center Options as the Unwinding Kicks into High Gear
More than a year ago, we posted a blog warning that call center statistics would be the canary in the coalmine as states began the unprecedented challenge of renewing coverage for all 92 million Medicaid enrollees now that the COVID-related continuous enrollment requirement has ended. We all know how frustrating it can be when you…
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Effective Medicaid Renewal Notices Are Key to Getting it Right During Unwinding
With the first week in May upon us, all 50 states have now begun initiating renewals for Medicaid enrollees, starting the clock on their unwinding process. We’ve already gotten a glimpse of what may be coming with data on coverage losses from Arizona and Idaho, both states that started terminations in April. The second wave…
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A Closer Look at CMS’s Proposed Rule to Improve Access to Care in Medicaid and CHIP
Editor’s Note: Since this post was published, CCF submitted formal comments on both the Medicaid Access and Managed Care proposed rules. The Biden Administration recently proposed two new rules on access to care in Medicaid and CHIP. The rules have long, formal titles: “Medicaid Program: Ensuring Access to Medicaid Services” and “Medicaid Program: Medicaid and…
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McCarthy Bill Would Radically Change Disability Standards for Medicaid and Reduce Coverage for Persons with Disabilities
As my colleagues Joan Alker and Edwin Park recently discussed, Section 321 of Speaker McCarthy’s debt ceiling bill, passed on a party-line vote in the House on April 26, 2023, would impose mandatory work reporting requirements on Medicaid nationwide, burdening states and worsening the health of millions of people. The Congressional Budget Office estimates this…
