Medicaid
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Federal and State Policymakers Must Address Alarmingly High Maternal Mortality Rates and Racial Disparities
The United States has an unacceptably high maternal mortality rate and it is getting worse. The latest data from the CDC shows that maternal mortality increased significantly between 2018 and 2019, topping out at the highest recorded rate since the agency began tracking the rate more than 30 years ago. A country’s maternal mortality rate…
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House Energy and Commerce Committee Releases Text of Medicaid/CHIP Reconciliation Provisions
Last night, legislative language was released by the House Energy and Commerce Committee (which has jurisdiction over Medicaid and the Children’s Health Insurance Program (CHIP)) – the “Build Back Better Act”. The Committee plans to “mark up” these provisions starting Monday — so things are now moving quickly inside the Beltway to move forward a…
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Transparency in Medicaid Managed Care: Findings from a 13- State Scan
Report Download the report. Appendix Online appendix tables. Blog Read the blog.
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Scan of 13 States’ Medicaid Managed Care Organizations Uncovers Need for More Transparency
At the beginning of July, North Carolina became the fortieth state to make the switch from fee-for-service (FFS) to Medicaid managed care. With the new system barely off the ground, a recent news report highlighted the stories of providers facing denied prior authorizations, delayed payments, and excessive paperwork. One provider stressed that she hadn’t received…
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New! Tips for Advocates on Preparing for Unwinding of the PHE Continuous Eligibility Provision
[Editor’s Note: A new version of our Tips and Best Practices for Unwinding the Medicaid Continuous Coverage Protection can be found here.] Although the end of the public health emergency (PHE) remains a moving target, it’s not too early to start planning for phasing out the continuous eligibility maintenance of effort provision and the eventual…
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Stakeholders Invited to Engage with DHS to Achieve a Fairer Public Charge Policy
Earlier this week, the Department of Homeland Security (DHS) issued an Advance Notice of Proposed Rulemaking (ANPRM) requesting broad public feedback on the public charge ground of inadmissibility. If you’re scratching your head at the idea of an “A”NPRM, you’re not alone. Think of it as a Request for Information (RFI) specifically tied to the…
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Medicaid Wars: The Unwinding (and Litigation) Continues (Episode IV)
It’s been seven months and change since the Biden Administration took office. What it found waiting for it on January 20 was not just a crisis of democracy and a global pandemic and a surge of unaccompanied children at the border, but also a large pile of policy intended to undercut the Administration’s ability to…
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New Report Underscores Need to Help Citizen Children from Mixed Status Families Enroll in Medicaid/CHIP
Ninety-seven percent of children living in the US are citizens, but one in four have an immigrant parent. New research from the Urban Institute shows that coverage gaps for citizen children with noncitizen parents widened relative to other children from 2016-2019, reversing much of the coverage gains these children experienced from 2013-2016. These findings are…
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Commonwealth Fund Blog Series on Medicaid Drug Pricing Issues
Congress and the Biden Administration are currently pursuing substantial drug pricing reforms as part of the reconciliation legislation expected to move this fall. While the focus is primarily on Medicare, Medicaid should not be overlooked. In an ongoing series of posts for the Commonwealth Fund’s To the Point blog, I examine some key Medicaid drug…
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Federal Government Accepting Public Comments on Tennessee Medicaid Block Grant Waiver Restricting Access to Prescription Drugs
The Centers for Medicare and Medicaid Services (CMS) have reopened a 30-day public comment period for Tennessee’s controversial section 1115 waiver, which the Trump Administration approved in January 2021. While the waiver’s radical centerpiece converting the state’s federal Medicaid funding into a block grant has rightfully received the most attention, the waiver would also allow…
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Participation of Eligible, Uninsured Children in Medicaid and CHIP Declined Again in 2019
[Editor’s Note: You can find state level Medicaid/CHIP participation rates on CCF’s State Data Hub.] Since the American Community Survey (ACS) was first released in 2008, the Urban Institute has estimated the share of uninsured children who are eligible but not enrolled in Medicaid and CHIP. Several weeks ago, Urban released its latest analysis based…
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Hidden in Plain Sight: A Medicaid Managed Care Pay-For
The Medicaid managed care market continues to grow. A review of the Q2 financial reports of the “Big Five” national managed care companies by my colleague Allie Corcoran finds that, over the first six months of 2021, Medicaid enrollment increased, on average, by 14.9 percent year-to-year. This increase is being driven in part by the…
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Medicaid Managed Care: 2021 Results for the “Big Five” at Q2
You’ve heard it here before: for children and families in forty states and the District of Columbia, managed care organization (MCO) performance determines if they get the care to which they are entitled. And, for many MCOs, this performance is influenced by the rules, regulations, and corporate culture of their national parent firm. As of…
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Biden Administration Takes Further Action to End Barriers to Medicaid Coverage
Nearly six months ago, the Biden Administration initiated efforts to withdraw work reporting requirements in the eleven states with approved section 1115 Medicaid waivers. Now, the resolution many have been waiting for is almost entirely complete. On August 10, Ohio, South Carolina, and Utah all received letters from CMS formally withdrawing their work requirement waivers.…
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CMS Takes Positive Steps to Protect Enrollees from Loss of Coverage at End of the PHE
A couple of weeks ago, I blogged about opportunities for the Biden Administration to make improvements to the December 2020 guidance issued to states on resuming routine eligibility and enrollment operations at the end of the public health emergency (PHE). At the top of the list was to give states more time to catch up…
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Medicaid Managed Care: Even Government Watchdogs Could be More Transparent
The Congressional Budget Office recently posted its new Medicaid baseline. These are CBO’s spending projections for Medicaid, which it uses in scoring legislative proposals. This FY 2021, which ends on September 30, CBO estimates that the federal government will spend $234 billion matching state spending on acute care services through managed care, more than twice…
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Q: How Many Children Were Uninsured in 2020?
A: We won’t ever know, but we do know a lot more could become uninsured in 2022. As regular readers of SayAhhh! know, we investigate this question every year with our annual report using data from the Census Bureau’s American Community Survey. Last year we found discouraging news for 2019 – the largest jump in…
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Research Update: Where Are Latinos Struggling to Access Healthcare?
Our recent report on coverage rates for Latino children and parents highlights geographic disparities in access to affordable health insurance. For example, while nearly 4 million Latino parents and 2 million Latino kids were uninsured in 2019, both groups were much more likely to have insurance coverage in California, which has expanded Medicaid, than in…
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New Report Highlights How COVID-Relief Funds Can Be Used To Strengthen and Expand Medicaid School Programs and Address Student Mental Health Needs
As the last few weeks of summer come to an end, families and school districts are preparing for the return of students to the classroom. After a year and a half of living and (largely virtual) schooling during an unprecedented pandemic, the start of this school year can serve as a prime opportunity for school…
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Missouri Medicaid Expansion Moves Forward
On July 22, the Missouri Supreme Court in a 7-0 decision ruled that Missouri’s voter-passed Medicaid expansion must proceed regardless of legislative foot-dragging and inaction by the Governor. The unanimous decision was decided on fairly simple legal grounds. The court noted that the voter-passed initiative had changed Missouri law and added the parents and other…
