Medicaid
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Tech Tuesday: HHS Provides Guiding Principles for Telephone Applications
“No wrong door,” a phrase coined to explain access to all the insurance affordability programs (Medicaid, CHIP and subsidized coverage through a Health Insurance Marketplace) through a single application process, is also often used to describe the different paths to enrollment. Beginning October 1, 2013, states are expected to allow individuals to apply online, over…
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Hospitals Should Exercise the Option to Enroll Kids in Medicaid through Presumptive Eligibility
Among many other provisions, the Affordable Care Act (ACA) gives hospitals the prerogative to make Medicaid presumptive eligibility (PE) decisions, regardless of whether the state has previously implemented PE. Presumptive eligibility allows states to train specific “qualified entities,” such as health care providers, schools, government agencies and community-based organizations, to screen for eligibility and temporarily…
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How Will Aligning Eligibility for Children in Medicaid Make Better Sense for Families and States?
By Wesley Prater The Affordable Care Act is most widely recognized for its expansion of affordable coverage to low-income parents and adults; however, a lesser-known feature of the ACA also helps children by aligning Medicaid coverage across families at 133% of the federal poverty level (FPL). Today, states must cover children under the age of…
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Aligning Eligibility for Children: Moving the Stairstep Kids to Medicaid
A feature of the Affordable Care Act (ACA) that has not received a lot of attention requires that Medicaid cover children with incomes up to 133 percent FPL as of January 2014. Today, there are “stairstep” eligibility rules for children. States must cover children under the age of six in families with income of at…
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Tech Tuesday: Two States Get Smart and Team Up on Medicaid Management Information System
Most of the attention on IT development has been focused on eligibility and enrollment systems, those customer-facing websites and online applications that collect data from the applicant and other electronic sources to determine eligibility. But behind the scenes, Medicaid Management Information Systems (MMIS) support the “backend” administrative functions such as provider enrollment, prior authorization, medical…
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There’s a Hole in Our Bucket: Addressing Children’s Health Insurance Churn
By Ashley Storms, New England Alliance for Children’s Health Pursuing health coverage for all children can sometimes feel like pouring water into a leaky bucket. Even when outreach and enrollment efforts are strong, a substantial portion of children will lose their insurance at least once. Unstable insurance coverage, known as “churn,” is inefficient and keeps…
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I Support Arkansas’ Effort to Move Forward (But Am Holding My Nose)
So I just skimmed through the Arkansas Section 1115 Medicaid waiver application,which was submitted to the federal government a few days ago. This proposal is unique and uses Medicaid funding to buy coverage in the new marketplace through a premium assistance arrangement. I AM happy that Arkansas legislators and the Governor were sensible enough to…
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On Anniversary of Medicaid, Let’s Celebrate Success in Providing Access to Care and Reducing Poverty
By Tara Mancini Tomorrow we celebrate the anniversary of Medicaid and its 48 years of providing health care access to those with low-income and the medically needy. Medicaid is less often recognized for its ability to provide economic stability to families, even though research has documented its ability to curb the burden of medical expenses.…
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GAO Releases New Report on Section 1115 Waiver Budget Neutrality
The latest GAO analysis of Medicaid Section 1115 waivers finds that the federal government does not always have a consistent policy of ensuring that the waivers are “budget neutral” to the federal government. GAO took a look at 10 Medicaid waivers approved in recent years to see whether there was a consistent policy that ensured…
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Children’s Medicaid/CHIP Crowd-Out Estimates by State
A new report by researchers at The Ohio State University College of Public Health finds that wealthier families who are eligible for public insurance are less likely to switch from private to public coverage than families earning less. The authors use ACS data and a regression discontinuity approach to obtain state estimates on how many…
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Arkansas Medicaid is Containing Costs Effectively so Why Go Private?
Just saw an interesting press release from Arkansas Medicaid agency on July 12th which says that “Arkansas Medicaid finished State Fiscal Year 2013 just 1.5 percent over the previous year’s spending, marking the program’s lowest annual growth rate in more than three decades.” Thanks to Dylan Scott’s article in Governing Magazine for calling this to…
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New Kaiser/Urban Report Highlights the Costs of NOT Extending Medicaid
By Martha Heberlein As many states are nearing or have reached the end of their legislative sessions, it’s a good time to take stock of who will implement the Medicaid expansion and the far-reaching implications of these decisions. Twenty-four states have decided to move forward with the expansion, 21 will not, and 6 continue to…
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CMS Issues Final Rule on New Premium Assistance Option
As my diligent colleague Tricia Brooks reported, CMS issued an important final rule on July 5th that we have been expecting for some time. While the rule did not finalize a number of issues, it did include slightly revised rules for states interested in pursuing premium assistance in the individual market – sort of a hot…
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All Eyes on States – Time to Say Goodbye to CHIP Waiting Periods
As states are rushing to get their enrollment and eligibility systems in top form going into 2014, HHS just handed them one more critical decision to make: getting rid of outdated CHIP waiting periods. Say Ahhh! readers know that eliminating CHIP waiting periods— or the period of time that a child must remain uninsured before…
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See How Your State Measures Up on Child Well-being: New Kids Count Data Is Available
By Tara Mancini Last week, the Annie E. Casey released the 24th edition of its Kids Count data book, a go-to source for trends on child well-being. This year’s analysis of national trends compares data from before and after the recession to see how children fare in its aftermath, and the results paint a mixed picture. Since…
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Connecting Kids to Coverage Grants Announced
The third round of Connecting Kids to Coverage Outreach and Enrollment Grants were announced today. A total of $32 million was awarded in 22 states to 41 grantees, which include state and local governments, tribal organizations, community groups, schools, health care providers and other organizations. Grants were targeted in the states with the largest numbers of…
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Translating MAGI to Current Monthly Income Will Be Particularly Important for Kids in Medicaid and CHIP
It’s helpful for all Medicaid and CHIP stakeholders to generally understand that starting in January 2014 there will be new ways to count income and household size to determine Medicaid eligibility based on the new ACA rules. While not everyone needs to dive into these policy weeds, there are a number of reasons it’s important…
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Florida’s Medicaid Managed Care Waiver Receives Final Approval: Some Strong Consumer Protections Included, Oversight Will Be Critical
So it may seem like this already happened but today CMS issued the final documents approving Florida’s request to move almost its entire Medicaid program into managed care. The state needed demonstration waiver approval for some (e.g. children on SSI, in foster care, dual-eligibles, etc) but not all of the populations it is seeking to move into…
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Making Medicaid Work for Child Welfare Populations: Insights from States
By Kamala Allen, Director of Child Health Quality at the Center for Health Care Strategies We know that many children in child welfare have significant health care needs – often exacerbated by trauma, abuse, and neglect – and that most are eligible for coverage through Medicaid. We also know that it can be difficult to…
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Covering Parents is Good for Kids: How Accepting the Medicaid Option Can Help Pennsylvania Kids
(Editor’s Note: This blog is based on testimony presented by the author before the Pennsylvania House of Representatives Human Services Committee today.) By George Hoover, Pennsylvania Partnership for Kids Pennsylvania has a strong history of providing health care coverage to children – a history that was built through bipartisan efforts and a commitment to “Cover…