Medicaid
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CMS Releases State-by-State Designations of Whether Certain Medicaid Categories Meet Minimum Essential Coverage Standards
The long-awaited assessment of whether certain Medicaid coverage categories meet minimum essential coverage (MEC) standards is out. Why is this important? This list serves two purposes: Individuals eligible for non-MEC Medicaid can qualify for premium tax credits and cost-sharing reductions. Individuals with non-MEC Medicaid coverage know whether they need to secure MEC to avoid the…
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Administration’s Budget Proposal Would Make Medicaid Expansion an Even Better Deal for Wisconsin and Other States
By Jon Peacock and Sashi Gregory, Wisconsin Council on Children and Families The proposed budget released this week by President Obama would make the expansion of Medicaid an even better deal for states like Wisconsin that have not yet taken up the option. If Wisconsin expanded BadgerCare (Wisconsin’s Medicaid program) eligibility in January 2017, the…
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A Wrap up of 2015 Medicaid Expansion Waivers: Montana And Michigan
By Sean Miskell and Joan Alker Although we have been closely following Medicaid expansion waivers, we have neglected heretofore to blog about two “M” states that received waiver approval in the last few months of 2015. Montana received approval on November 2, 2015 to start its new coverage on January 1, 2016, and Michigan received…
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1095B Forms May Cause Problems for Enrollees Who Transition from Marketplace to Medicaid Coverage
It’s tax time, and there is more to be said about the many issues that swirl around reconciliation of premium tax credits and accurate assessment of the penalty for going without health insurance. But there is one issue in particular that I am worried about for consumers who were enrolled in a Marketplace plan with…
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2016 Federal Poverty Levels Are Out; What Does This Mean for the Marketplace and Medicaid?
Last week, the 2016 federal poverty levels (FPL) were published in the federal register. How does this impact consumers applying for coverage through the Marketplace, Medicaid or CHIP? Let’s start with eligibility for Marketplace subsidies. For 2016 calendar year coverage, regardless of when someone applies or enrolls, eligibility is based on the 2015 FPL levels.…
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“Healthy Students” Initiative Seeks to Help Children Achieve Better Health & Academic Success
Health care coverage helps children show up for school ready to learn and provides parents with the peace of mind of knowing they can afford to get their children the care they need to succeed. Sadly, many of America’s children are going without affordable coverage even though they are eligible for Medicaid or CHIP but…
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Little Known Provision Keeps Kids From Slipping Through Cracks Due to Differences in Eligibility Rules
For the most part, the Affordable Care Act aligns the way that Medicaid determines eligibility based on the same Modified Adjusted Gross Income (MAGI) rules used to determine eligibility for financial assistance in the Marketplace. But there are exceptions in Medicaid as I outlined in this blog. The differences can mean that an individual is…
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Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey
Executive Summary January 2016 marks the end of the second full year of implementation of the Affordable Care Act’s (ACA) key coverage provisions. This 14th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies provides a point-in-time snapshot of policies as of January 2016 and identifies changes in policies that occurred…
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Survey Shows States Made Significant Progress Implementing Data-Driven Eligibility in Medicaid
Eligibility decisions made in real-time or overnight when someone submits a Medicaid application? Automated determinations of ongoing eligibility at renewal without requiring enrollees to fill out forms or send in paperwork? It wasn’t too long ago that many Medicaid stakeholders would have thought those were pie-in-the sky notions. Yet, thanks to new high-performing eligibility systems…
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Children’s Health Coverage in Arizona: How Are Children Doing Without KidsCare?
Arizona, with its large number of uninsured residents, was primed to make major progress in 2014 with the full implementation of the Affordable Care Act. With the adoption of the Medicaid expansion, the state did see coverage improvements that mirrored national trends. Yet the state’s decision to dismantle KidsCare meant some Arizona children likely fell…
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Many Working Parents and Families in Virginia Would Benefit from Medicaid Coverage
Virginia is one of the 20 states that has elected not to accept federal funding under the ACA to extend Medicaid coverage to parents and other low-income adults. Consequently, parents in Virginia are not eligible for Medicaid or premium tax credits if their incomes exceed approximately 45 percent of the poverty line (45 percent of poverty is…
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NEACH Summit Highlights Continuous Battle for Health Care Access and Coverage for Children
By Ben Koller, Community Catalyst Last month, children’s health advocates and experts from around New England gathered for the New England Alliance for Children’s Health’s (NEACH) annual Children’s Health Care Summit. NEACH, an initiative of Community Catalyst, is a broad-based coalition of health advocates, providers, and legal experts dedicated to improving children’s access to high-quality,…
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Permanent 90/10 Rule Will Help States Continue Efforts to Modernize IT Systems
Although final publication of the 90/10 rule – providing generous, enhanced federal funding for Medicaid eligibility and enrollment systems – doesn’t quite bring the surprise of opening an unexpected holiday gift, it is still gives us many reasons to celebrate. If CMS had allowed the enhanced funding to expire as initially planned, states would have…
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Premium Assistance and Wrapped Benefits Part 2: A Startling Discovery
As I blogged about last week, our recent report with co-authors at the Kaiser Commission on Medicaid and the Uninsured looked at wrapped benefits and how they are working in selected Section 1906 premium assistance programs. The most startling discovery to me was the finding that families have no cost-sharing protections in the programs we…
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Senate reconciliation bill repeals key children’s health provisions
So despite a bipartisan CHIP extension earlier this year, it appears that children’s coverage is not as popular as we may have thought. In fact, if the reconciliation bill as passed becomes law there is a good reason to believe that millions of children would become uninsured; almost assuredly the historic and steady reductions in the…
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Medicaid Premium Assistance Programs: What Information is Available About Benefit and Cost-Sharing Wrap-Around Coverage?
States have long used Medicaid funds as premium assistance to purchase private health insurance for beneficiaries as an alternative to providing coverage directly through the state Medicaid program. States using premium assistance generally must provide wrap-around benefits and cost-sharing protections so that Medicaid beneficiaries receiving private coverage will not have access to fewer benefits or…
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Premium Assistance and Wrapped Benefits: Do They Work?
Author’s note: This is the first in a two (or possibly three) part blog series – the next installment will ponder this question with a particular eye to the future of children’s coverage… Along with co-authors MaryBeth Musumeci and Robin Rudowitz at the Kaiser Commission on Medicaid and the Uninsured, Sean Miskell and I undertook…
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Arkansas and Arizona Drive in Different Directions on Medicaid Transportation Benefit
By Sean Miskell Most observers expect that remaining states that have not yet expanded Medicaid are likely to seek changes to the program via waivers as they move forward on expansion. A few states that have already expanded Medicaid are also seeking to make changes through waivers. But these changes are not always for the…
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Comments Submitted On Texas Medicaid Waiver
Georgetown CCF, the Center on Budget and Policy Priorities and seven other national organizations submitted a letter to CMS for public comment on Texas’ proposal to extend its Section 1115 Medicaid demonstration project, the Texas Healthcare Transformation and Quality Improvement Program. The full comments that were submitted November 16, 2015 can be found here –…
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$32 Million Now Available to Help Reach Eligible but Unenrolled Kids
Most uninsured children are eligible for Medicaid or CHIP but are not yet enrolled so finding them and helping them enroll is critical to successfully reducing the uninsured rate for children. As my colleague Tricia Brooks has pointed out many times, it is no secret that sustained outreach and enrollment support is the key to…