Medicaid

New & Noteworthy

PRescription Drugs
What Happens to Medicaid Drug Policy if the ACA is Overturned?

The repeal of the ACA could mean loss of Medicaid coverage for up to 15 million that were enrolled in the ACA Medicaid expansion group prior to the COVID-19 pandemic. Repeal could also mean significant changes to Medicaid prescription drug policy with implications for state and federal spending for prescription drugs for non-expansion Medicaid enrollees.
Tracker
Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19
Information on approved Medicaid emergency authorities to address the COVID-19 Coronavirus emergency. We include details on Medicaid Disaster Relief State Plan Amendments (SPAs), other Medicaid and CHIP SPAs, and other state-reported administrative actions; Section 1115 Waivers; Section 1135 Waivers; and 1915 (c) Waiver Appendix K strategies.
Waivers
The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 Election
As the Trump administration reaches the end of its first term, this issue brief considers the landscape of approved and pending Section 1115 Medicaid demonstration waivers and how the election may affect it. Section 1115 waivers generally reflect priorities identified by the states and CMS, as well as changing priorities from one presidential administration to another.
Disabilities
People with Disabilities Are At Risk of Losing Medicaid Without the ACA Expansion
The ACA Medicaid expansion is a pathway to coverage for people with disabilities whose health needs do not rise to the SSI level. These enrollees include people with serious, and often multiple, functional limitations, including some near elderly. If the Supreme Court invalidates the ACA, most expansion enrolles would likely become uninsured.

20th Annual Medicaid Budget Survey

Medicaid Enrollment & Spending Growth: FY 2020 & 2021
Following several years of declining or flat enrollment growth, states expect Medicaid enrollment and spending each to jump by more than 8 percent in fiscal year 2021, chiefly due to a slumping economy amid the pandemic and federal conditions to maintain coverage to access enhanced federal matching funds. The Medicaid program increasingly will be relied upon to provide health coverage and help soften the economic blow of the pandemic — all at a time when states’ financial capacity to provide such services is stretched thin.
State Medicaid Programs Respond to Meet COVID-19 Challenges: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2020 and 2021
Our annual in-depth, state-specific examination of policy changes and initiatives in Medicaid programs find that this year many involve responses to the COVID-19 pandemic. We present the latest on eligibility and enrollment, provider rates, delivery systems, long-term services and supports, pharmacy actions, benefits, cost-sharing, telehealth and more.

The Essentials

Tracker
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
Bookmark our Medicaid waiver tracker page for the latest information on pending and approved Section 1115 Medicaid waivers.
The Basics
10 Things to Know about Medicaid
Medicaid covers 1 in 5 low-income Americans, including many with complex and costly needs for care.
Data Collection
Medicaid Managed Care Market Tracker
Sixty-nine percent of Medicaid beneficiaries nationally get care through managed care organizations. Get state-level, MCO-level and parent firm-level data.
Managed Care
10 Things to Know About Medicaid Managed Care
53.9 million Medicaid beneficiaries (69%) received their care through comprehensive risk-based managed care organizations (MCOs), as of July 2018. In FY 2019, payments made to Medicaid MCOs accounted for about 46% of the nearly $604 billion that states and the federal government spent on Medicaid services that year.