Medicaid Expansions

Twenty-six states and the District of Columbia are now implementing health reform’s Medicaid expansion. Arkansas, Iowa, and Michigan have expanded through federally approved Medicaid demonstration projects, or “waivers.” This brief considers the guardrails the federal government has established so far around what is and is not permissible in a Medicaid expansion waiver, and provides useful lessons for policymakers in states considering whether to expand Medicaid.
 

This report series explains how expanding Medicaid would give uninsured Americans access to affordable health insurance, create a healthier workforce, and strengthen state economies. The series focuses on 10 states: Alabama, Florida, Indiana, Missouri, North Carolina, Pennsylvania, Tennessee, Texas, Utah, and Virginia. These reports show that, in these states, more than half of the residents who could benefit from Medicaid expansion are working adults, and that they work in occupations that make up the foundation of the state’s economy.
 

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.
 

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.

Fast-track enrollment strategies do more than help people sign up for Medicaid—they save states money. These strategies speed up the eligibility process by allowing states to use information they already have on file from other public benefit programs. By vastly reducing the time eligibility workers spend processing Medicaid applications, fast-track strategies can reduce administrative expenses. This brief examines the costs and savings of two states—West Virginia and Illinois—implementing fast-track enrollment in Medicaid.

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 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.

The Centers for Medicare and Medicaid Services recently released information on how many additional people were enrolled in coverage through Medicaid and CHIP since October 1, 2013, when the first open-enrollment period for the new health insurance marketplaces was launched, through April 2014, the most recent information available. This brief assesses how reported changes in enrollment in Medicaid and CHIP during this period compare with changes in Medicaid/CHIP enrollment projected by the end of 2016 by the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM).
 

This monthly report on state Medicaid and Children’s Health Insurance Program (CHIP) data represents state Medicaid and CHIP agencies’ eligibility activity for the calendar month of April 2014. While the initial open enrollment period for the Health Insurance Marketplace ended on March 31, Medicaid and CHIP enrollment continues year round. CMS reports that Medicaid and CHIP enrollment grew by 1.1 million in April, which brought the total Medicaid and CHIP enrollment to 65 million people by the end of that month.
 

Many states are incorporating policies into their Medicaid programs that seek to enhance beneficiaries’ ability to make informed decisions about their health and health care and become more active, engaged participants in the health care system. Several of these consumer incentive programs are tied to a broader state effort to use federal funds to extend coverage to a previously uninsured population. This technical assistance tool provides examples of consumer incentives and personal responsibility in Medicaid programs across the nation, including strategies used in new alternative expansion models.