Medicaid
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North Carolina Finds Innovative New Way to Provide Families with Needed Medical Debt Relief
As a nonprofit health attorney over a decade ago I worked in North Carolina on pushing hospital systems to eliminate the practice of suing lower income patients for medical debt and associated abuses like pursuing liens against the houses of poor families. A Pulitzer-prize nominated newspaper series detailed the situation at the time in North…
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Future of Medicaid Likely Hinges on Election but Voters Are Not Yet Hearing About Candidates’ Views
By Joan Alker and Michael Perry We’ve worked on Medicaid policy and/or public opinion research for three decades now and have observed its growing importance as the backbone of our health care system – now covering approximately 80 million people — as well as its centrality to voters. Medicare and Social Security are often described…
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Back-to-School Season is Key to Reconnecting Kids to Health Coverage
More than 5 million children have lost Medicaid coverage since states began the process of unwinding the pandemic continuous coverage protection. And recently released data from the National Health Insurance Survey (NHIS) for the first quarter of 2024 adds to our concerns that children are losing access to the health care they need to succeed.…
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Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q2 2024
The Q2 2024 earnings reports for the “Big Five” Medicaid managed care companies are in. They tell us that the PHE unwinding is winding down, but it’s still driving declines in Medicaid enrollment for the companies as a group. Here are the numbers. For the fifth consecutive quarter, beginning with Q2 2023, Medicaid enrollment for…
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Prominent Conservative/GOP Plans Share Common Priority: Medicaid Block Grants and Per Capita Caps
The Project 2025 blueprint, the fiscal year 2025 Republican Study Committee budget plan, and the fiscal year 2025 House budget resolution all propose draconian Medicaid cuts, with a centerpiece of capping and cutting federal Medicaid funding through block grants and/or per capita caps. Together, they signal that radically restructuring Medicaid would likely be a high…
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Community-Based Assistance Programs Support Applicants Where They Live and are a Gold Standard for Outreach
In this final installment of our series on Medicaid and CHIP outreach, we look at community-based assistance programs and resources in each state. Personalized assistance is critical to helping individuals and families find and access support to navigate confusing processes. CCF’s state outreach snapshot found state-supported outreach assistance programs in 30 states. Most, states with…
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GAO Releases Report on Federal Oversight and the Unwinding
There are many lessons to be learned from the unwinding, but among the top items on the list is the discovery that many states are not following federal renewal regulations that have been in place for more than a decade. Noting that, the Government Accountability Office (GOA) has released a report entitled: “Medicaid: Federal Oversight…
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This Year’s House Republican Budget Resolution Also Includes Severe Medicaid Cuts
While Medicaid continues to fly beneath the radar as an election issue, it is increasingly clear that the results of this fall’s federal elections will determine whether Medicaid will be at serious threat of deep and damaging cuts next year. I have previously written about the severe Medicaid cuts proposed in the Project 2025 blueprint…
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Medicaid Drug Rebate Program News and Notes, 2024 Edition
Periodically I write up news on the Medicaid Drug Rebate Program (MDRP) and here’s another (albeit overdue) edition highlighting some recent MDRP policy developments: The Centers for Medicare and Medicaid Services (CMS) will not finalize its proposal to require manufacturers to “stack” discounts when determining best price under the MDRP. The best price requirement, which…
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Loper Bright Decision Will Collapse on Itself, Policy Evidence is More Important than Ever Before in Driving Progress
We blogged recently about the Supreme Court’s historic power grab in the Loper Bright case, which turned agency law on its head by overturning the Chevron case, the cornerstone of modern agency law. In Loper Bright, the Supreme Court’s clear intention is to weaken federal agencies, which is readily apparent in the decision itself and,…
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Tennessee to Begin Providing Diapers for Children Under Age 2 in Medicaid
Following CMS approval of its 1115 demonstration amendment earlier this year, Tennessee is set to begin covering diapers as a Medicaid benefit on August 7th. All children under age two enrolled in Medicaid and CHIP (known as TennCare and CoverKids, respectively) will be eligible to receive up to 100 diapers per month as a covered…
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What to expect from Census data this fall on Child/Adult Coverage Levels?
As readers of SayAhhh! know, Georgetown CCF does an annual report on children’s coverage every fall using the most recent data from the Census Bureau’s American Community Survey (ACS), which is typically released in September. This year, the 2023 data will be released on September 12th; the Census Bureau’s Current Population Survey (CPS) Annual Social…
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Transparency in Medicaid Managed Care: CMS Posts the MCPARs
There’s been a startling—but VERY welcome—development in the long-running MCPAR saga. On July 15, CMCS posted on its medicaid.gov the first three tranches of Managed Care Program Annual Reports (MCPARs) submitted by state Medicaid agencies for performance year 2023. The agency promises to post the remaining tranche for performance year 2023 in October, with quarterly…
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Another Sign That Trump 2 Will Target Medicaid for Deep, Damaging Cuts
What would a second Trump Administration have in store for Medicaid? The Project 2025 blueprint includes truly draconian cuts just like the House Republican Study Committee budget plan does. Now, a new report from the Paragon Institute provides yet another sign that Medicaid will be targeted – it recommends deep and damaging cuts in federal…
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States Revised Data Show Mixed Outcomes for Pending Renewals but Disenrollment for Procedural Reasons Still High
We have previously called attention to the large share of pending renewals in many states, which can be an indication that a state is not able to keep up with the workload. However, some states specifically chose to extend renewal due dates out an extra month or two to conduct more targeted outreach; those renewals…
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Medicaid and CHIP Outreach Snapshot Blog Series
Earlier this year, CCF published a snapshot of state Medicaid and CHIP outreach activities. The report provides an analysis of state-provided outreach resources and enrollment assistance. This blog series highlights good examples of state outreach and enrollment efforts and identifies areas that need improvement. Read the snapshot report Read the introductory blog Read the blog on social media…
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How States Can Use Tax and Unemployment Filings to Sign People Up for Health Insurance
This spring, as millions of people prepared their taxes, an increasing number of states were using the tax-filing process to connect those who are eligible but uninsured with comprehensive, affordable health insurance. These “easy-enrollment programs” allow filers to check a box on forms they file with the state (e.g., income tax returns) to indicate that they…
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CMS Proposes Rule to Codify 12-Month Continuous Eligibility and Improvements to Maternal Health
CMS released a proposed rule related to Medicare hospital outpatient and ambulatory surgical center payments that also includes provisions codifying the Consolidated Appropriations Act of 2023 (CAA) requirement that states provide 12-months of continuous eligibility to all children in Medicaid and CHIP under age 19 as of January 1, 2024. While most of the rule…
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Improving Access in Medicaid Managed Care Using State Directed Payments
The Centers for Medicare & medicaid Services (CMS) recently released new Medicaid managed care regulations that update CMS policy on State Directed Payments (SDP). In this blog we’ll cover what SDPs are, how they can be used to improve access to care, and some changes in how CMS will allow and regulate them. You can…
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CMS Expresses Concern over States with Large Shares of Application Backlogs
Much has been written about the enormous task state agencies have faced as they returned to routine operations during the unwinding of the Medicaid continuous enrollment requirement. While the primary focus (rightfully) has been around renewals and the renewal process, states have other eligibility and enrollment operational responsibilities including processing applications for new applicants or…
