Medicaid Expansions

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 during 2015. Coverage is driven by two key elements—eligibility levels determine who may qualify for coverage, and enrollment and renewal processes influence the extent to which eligible individuals are enrolled and remain enrolled over time. This report provides a detailed overview of current state policies in these areas, which have undergone significant change as a result of the ACA.

This study examines the experiences of low-income adults during the first year of the ACA Medicaid expansion in three states that adopted different strategies: Kentucky, which expanded traditional Medicaid coverage; Arkansas, which used the private option; and Texas, which did not expand Medicaid. It found that low-income adults in Kentucky and Arkansas were more likely to be insured and less likely to have problems paying medical bills or affording prescriptions than low-income adults in Texas.

The Centers for Medicare and Medicaid Services preliminary spending and enrollment data from the Medicaid Budget and Expenditure System (MBES) that covers the period from January 2014 through December 2014, during which 27 states including D.C., had implemented Medicaid expansion. This brief examines the MBES data to examine the effect the Medicaid expansion on spending and enrollment.

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Many individuals involved in the criminal justice system are now eligible for Medicaid in states that expanded Medicaid under the ACA. Health coverage can provide individuals who are leaving incarceration with access to physical and behavioral health services critical to their successful reentry into the community. This new toolkit highlights the efforts of select states to enroll individuals involved with the criminal justice system. The toolkit is designed to provide state officials with actionable information about policies and practices available to connect justice-involved individuals to health care coverage through Medicaid.

To date, nine states have launched Accountable Care Organization (ACO) programs for all or part of their Medicaid population, and 10 more are actively pursuing ACOs. While state ACO models differ widely, all share the following core components: payment model, quality measurement approach, and data strategy. This brief summarizes these core ACO characteristics and profiles how nine states – CO, IL, IA, ME, MN, NJ, OR, UT, and VT – have incorporated these elements into their Medicaid ACOs. For each state, it outlines key ACO infrastructure; details unique payment, quality, and data approaches; and spotlights one of the state’s Medicaid ACOs.