The American Health Care Act has a number of policy changes that impact state Medicaid programs. This webinar featured experts at Manatt Health as they review implications on Medicaid Financing, Eligibility and other programmatic changes for states. The attached slides provide significant insight into eligibility changes, the policy principles of the per capita cap and block grant models, and an in-depth explainer of the creation of per-capita caps for states.
Medicaid Expansion and Enhanced Match: How Proposals to Grandfather Medicaid Enrollees Could Impact States
Some federal proposals implement enrollment freezes for the Medicaid Expansion population, while grandfathering the enhanced match for enrollees that remain in the system. States have experiences with enrollment freezes in recent years and the changes in enrollment levels provide lessons for states moving forward. This issue brief, authored by the team at Manatt Health, highlights the experiences of three states and how enrollment freezes impact state Medicaid rolls.
While the focus of debate regarding repeal of the Affordable Care Act (ACA) has been on Marketplaces and the Medicaid expansion, myriad other provisions of the ACA are at risk of repeal—including those that streamline Medicaid eligibility and enrollment systems and implement a national, simplified standard for income eligibility. As of January 2016, 37 states are able to complete an eligibility determination in real time, defined as less than 24 hours, and among these, 11 states report that at least half of their applicants receive an eligibility determination in real time. The future of the ACA’s streamlined eligibility and enrollment-related provisions and the system improvements states have invested in to implement them are the subject of this issue brief.
On February 15, 2017, CMS released a proposed rule on market stabilization in the individual market nationally. The State Network hosted a webinar for state insurance departments and state-based marketplaces to review the topics addressed in the rule, and identify policy implications for states. This slide deck highlights the points of the webinar and includes all of the specific questions on which CMS requested feedback.
Because Medicaid is the single largest payer in every state, governors are using Medicaid to drive multi-payer reforms, including adoption of value-based payment methodologies and advancement of population health models. Proposals being considered by Congress and the new administration to repeal the Affordable Care Act’s (ACA) Medicaid expansion and implement limits on federal Medicaid funding through block grants and per capita caps could have a significant impact on these advances. This issue brief, developed by Manatt Health, considers how much states have accomplished to drive value in and through their Medicaid programs over the last 50 years, and most especially over the last five years, and what states stand to lose in terms of progress and innovation in their Medicaid programs and health care delivery systems if federal support for Medicaid is reduced.
Data Points to Consider When Assessing Proposals to Cap Federal Medicaid Funding: A Toolkit for States
Key leaders in Congress and high-ranking members of the Trump Administration are proposing major changes to Medicaid financing through the adoption of a block grant or per capita caps. To assist states in assessing the potential implications of proposals to cap federal Medicaid funding, the State Network team at Manatt Health has developed a toolkit providing state-by-state data on Medicaid enrollment and expenditure trends—factors that are central to establishing the amount each state would be allocated under various capped funding proposals.
Recent proposals for the incoming Congress and presidential administration to repeal the Affordable Care Act (ACA) have also included calls for an overhaul of the current Medicaid program financing structure. Such a change, aimed at reducing federal Medicaid spending, would have significant implications for state Medicaid programs. A new webinar examined these proposals and the potential impact that they could have on states.
Section 1115 waivers allow states to waive certain Medicaid statutory requirements in order to advance state policy priorities and test innovations in their Medicaid programs, provided that they are budget neutral and "further the goals of the Medicaid program." Since 2014, seven states have used 1115 waivers to implement alternative Medicaid expansions, and these waivers are likely to be leveraged by states in the next four years to advance changes to Medicaid. This issue brief, developed by Manatt Health, provides an overview of the features of these alternative Medicaid expansion waivers.
Proposals for the incoming Congress and presidential administration to repeal the Affordable Care Act (ACA) have also included a call for a fundamental overhaul of the Medicaid program by imposing caps on federal funding to states. Such capped funding would replace the central feature of Medicaid's financing structure, the federal government's legal obligation to share all allowable state Medicaid costs. While the design of various proposals to cap federal Medicaid funding may differ in several ways, they all aim to allow the federal government to achieve budget certainty and reduce federal Medicaid spending.
Medicaid expansion under the Affordable Care Act (ACA) has had a positive impact for states, both in terms of the number of people covered and the budget savings and revenue gains that they have realized as a result. A series of recent reports demonstrates the economic impact in states that have expanded Medicaid. A new webinar examined potential repeal of Medicaid expansion under the ACA, and what this would likely mean for states.