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Medicaid

  • CMS Released Additional Resources to Help Medicaid and CHIP Enrollees Retain Coverage

    Hannah Green

    March 31 marks the one-year anniversary of the end of the COVID-related Medicaid continuous enrollment requirement. While it was expected that renewing nearly 90 million Medicaid enrollees would be a heavy lift for states, it’s taking some states longer to complete renewals due to system changes and efforts to improve ex parte renewal rates or…

  • New ASPE Report: 17 Million Children Live in States That Could Benefit from 12 Months Continuous Coverage in Medicaid and CHIP

    Joan Alker

    One commonsense policy change can make a huge difference in the lives of children. A new federal report released yesterday finds that the 12-month continuous eligibility period for children in Medicaid and CHIP that took effect on January 1, 2024 will protect more than 17 million children who live in states that previously did not…

  • Biden Administration Adds Protections to Keep Children Covered in CHIP

    Joan Alker

    Today the Biden Administration announced the final federal regulation “Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” which, among other things, eliminates outdated red tape barriers to coverage for children insured through the Children’s Health Insurance Program (CHIP) that have been in place since its…

  • Call Center Data Shows Trends Across States, But May Not Provide Full Picture

    Ella Mathews

    Before the unwinding began, Tricia Brooks highlighted why call center data would be an important piece of the puzzle in understanding how states’ returns to routine operations were going. Reporting call center data, along with other data reporting requirements enacted by the Consolidated Appropriations Act, 2023 (CAA) help CMS track how the unwinding is going…

  • Update: Georgia Now Suing CMS For Denying an Extension Request That Hasn’t Really Even Been Filed

    Cathy Hope

    As we have recently covered, and as we explained before it launched, Georgia’s “Pathways to Coverage” demonstration is riddled with defects. Pathways is the state’s alternative to a standard Medicaid expansion—an expansion with work requirements that has resulted in Georgia enrolling (as best we can tell) less than one percent of those eligible (yes, that’s…

  • Medicaid Managed Care Appeals and Grievances:  GAO Takes a Look

    Andy Schneider

    Last week, GAO issued a performance audit of data on Medicaid MCO appeals and grievances. The database GAO examined was the first year of Managed Care Program Annual Reports (MCPARs) submitted by state Medicaid agencies to CMS.  MCPARs are one of three reports on which CMS relies to conduct oversight of state managed care programs…

  • Latest House Republican Study Committee Budget Plan Again Includes Draconian Medicaid Cuts

    Edwin Park

    On March 20, 2024, the Republican Study Committee (RSC), whose members comprise more than three-quarters of the House Republican caucus, announced its fiscal year 2025 budget plan.  The budget plan proposes to cut total federal Medicaid, Children’s Health Insurance Program (CHIP) and Affordable Care Act marketplace subsidy spending by nearly 54 percent over the next…

  • CMS Informational Bulletin Calls Out 10 “Do Nots” in Conducting Renewals

    Hannah Green

    In an Informational Bulletin (CIB) released on March 15, 2024, CMS reminds states of their obligation to comply with all existing federal renewal requirements in Medicaid and CHIP. The CIB is the result of questions CMS has received from states, stakeholders, and external partners regarding the permissibility of certain renewal practices. The CIB describes 10…

  • Medicaid and CHIP Provisions in Biden Administration’s Fiscal Year 2025 Budget

    Edwin Park

    On March 11, the Biden Administration issued its budget plan for fiscal year 2025. Based on budget documents from the Office of Management and Budget (OMB) and the Department of Health and Human Services (HHS), here’s a brief summary of the budget’s major provisions related to Medicaid and the Children’s Health Insurance Program (CHIP), along…

  • Surveys Show Unwinding Awareness Lags, Highlighting Need for Outreach

    Hannah Green

    If you know Medicaid, you know that everything is not fine right now. The unwinding of the pandemic continuous coverage provision continues to have major effects on enrollment, with the net decline in child enrollment now exceeding 4 million. Administrative data from across the country show that 73.2% of people who are losing coverage are…

  • Survey Looks at Medicaid Unwinding Experiences for Spanish Speakers

    Guest

    By Melody Emenyonu, CCF communications intern, and Kelly Whitener The Protecting Immigrant Families recently partnered with UnidosUS and Noticias Para Inmigrantes to conduct a survey focused on Spanish-speaking adults and their experiences with Medicaid unwinding and the re-enrollment process. All 2,125 participants of the survey had at least one member of their family enrolled in…

  • CMS Releases Updated Medicaid & CHIP Telehealth Toolkit, Includes State Best Practices and Behavioral Health Strategies

    Anne Dwyer

    This month, CMS released an updated State Medicaid and CHIP Telehealth Toolkit consolidating information from previous toolkits and providing additional guidance – as required by the Bipartisan Safer Communities Act – on issues from billing best practices to strategies for using telehealth in schools. In addition to FAQs on issues such as benefit flexibility, financing,…

  • If You Love Children, You Should Love these Medicaid/CHIP Policy Changes in 2024

    Hannah Green

    Before the new year slips from memory, I wanted to take stock of a few good things happening for kids covered by Medicaid and CHIP this year. Amidst all the dismal news about how nearly 4 million children have lost their coverage during the unwinding – many remain eligible but lost coverage due to red…

  • Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q4 2023

    Ella Mathews

    Q4 2023 was also the third quarter of the PHE “unwinding”—the redetermination of eligibility for all 86.7 million Medicaid enrollees following the expiration of the Public Health Emergency continuous coverage provision in March 2023. These redeterminations have resulted in the disenrollment of over 16 million Medicaid enrollees as of January 2024, which translates into a…

  • A Lifeline for Families of Children With Special Health Care Needs

    Guest

    By Gabby Benitez, Kristen Golden Testa and Nick Lutton Nine months after the start of a national effort to renew Americans’ Medicaid coverage, a tidal wave of people, including almost 200,000 children in California from June through October last year, lost their coverage – and an untold number may be joining them. Most disturbingly, this…

  • Medicaid Expansion in Georgia would Improve Maternal and Infant Health Outcomes

    Hannah Green

     One in ten Georgians report knowing someone who has died through pregnancy-related causes. An estimated 57% of Georgians have experienced or know someone who has experienced maternal morbidity. Over 70% of Georgians believe that prioritizing improvements in access to health insurance coverage would help to reduce maternal mortality. These statistics were shared at the…

  • Where do Things Stand with Medicaid Unwinding at the Halfway Point?

    Joan Alker

    KFF’s new research finds that states have reported outcomes for about half of Medicaid renewals nationwide, and so far 16.2 million people have been disenrolled. Meanwhile, our CCF tracker (which accounts for movement on and off the program as well as new enrollment by looking at net enrollment change in each state) shows a 9.37…

  • Minnesota Medicaid Revisits the Question: Managed Care or Fee-for-Service?

    Andy Schneider

    In the beginning, there was fee-for-service (FFS). In this case, the beginning was 1965, when Medicaid (and Medicare) were enacted. FFS was the way that these public programs, as well as almost all private insurers, purchased health care. Fast forward to today. Propelled by an interest in budget predictability and federal policy changes giving them…

  • Multi-Year Continuous Eligibility for Children

    CCFadmin

    As of January 1, 2024, all states are required to provide 12 months of continuous health coverage for children in Medicaid and the Children’s Health Insurance Program (CHIP). This reduces the risk of eligible children losing coverage due to administrative barriers or temporary fluctuations in family income. In 2022, Oregon became the first state approved…