Medicaid Expansions

Medicaid is the largest health insurance program in the United States, covering both acute and long-term care services for over 66 million low-income Americans. Medicaid is currently undergoing its biggest change since its inception due to the implementation of the ACA. These changes will affect which individuals—and how many—may enroll in the program and how care is delivered. Policymakers in the 50 states and the District of Columbia, cautious about Medicaid’s claim on state revenue, need to know how the changes will affect state budgets and residents’ health. This report, the first in a series, focuses on the impact of Medicaid on the states, including trends in spending and enrollment, and the anticipated effects of the ACA.

High-performing health plans are critical to the success of efforts to align Medicare and Medicaid services, including the capitated financial alignment demonstrations as well as Dual Eligible Special Needs Plans. Yet, there is little consensus about what makes an integrated health plan high-performing. This brief introduces a framework of key attributes of high-performing health plans. While the framework is intended as a guide rather than a set of formal criteria, it can help states and health plans establish the elements essential to successfully providing coordinated, person-centered, integrated care that meets the needs of individuals with complex needs.
 

This proposed rule provides guidance on eligibility redeterminations and renewal of coverage through Health Insurance Marketplaces for plan year 2015. This rule offers Marketplaces two new alternative options for conducting annual redeterminations. It also details the requirements for the content of the renewal or discontinuation notices that health insurance issuers must send to their enrollees before the first day of the open enrollment period.

Medicaid is the largest health insurance program in the United States, covering both acute and long-term care services for over 66 million low-income Americans—children and their parents, as well as elderly and disabled individuals. This report focuses on the impact of Medicaid on the states, including trends in spending and enrollment, and the anticipated effects of the ACA.
 

This analysis uses evidence from the economics and health policy literatures to quantify several important consequences of States’ decisions not to expand Medicaid. That evidence, which is based primarily on careful analysis of the effects of past policy decisions, is necessarily an imperfect guide to the future, and the actual effects of Medicaid expansion under the ACA could be larger or smaller than the estimates presented below. However, this evidence is clear that the consequences of States’ decisions are far‐reaching, with implications for the health and well‐being of their citizens, their economies, and the economy of the Nation as a whole.