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Medicaid Eligibility

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Blog

This blog describes how the American Rescue Plan Act expanded access to affordable health insurance coverage in a variety of ways.

Commentary

This commentary examines how in late June, the U.S. Department of Health and Human Services (HHS) issued its first proposed rule governing the health insurance markets and marketplaces.

Report

This report examines how a public option that typically pays Medicare rates would considerably reduce the cost of increasing coverage in the Medicaid gap.

Report

This report assesses racial disparities in the quality of inpatient care using 11 patient safety indicators that measure rates of adverse patient safety events of hospital-acquired illnesses or injuries.

Commentary

This commentary explains the federal government’s goal of reducing new HIV infections by 90% by 2030, the CDC has identified two policy strategies that states can employ for HIV prevention – provision of Pre-Exposure Prophylaxis medication and availability of Syringe Service/Exchange Programs.

Podcast

This podcast covers how effective data measurement is critical for Medicaid programs seeking to advance health equity and better understand different experiences of populations served by the program.

Commentary

This commentary examines how Washington implemented the nation’s first public option for the 2021 plan year and in the first six months of 2021, states made significant progress in advancing public option proposals, with public option legislation advancing in Colorado, Nevada, and Oregon.

Commentary

This commentary examines how recent approval of the Alzheimer’s drug Aduhelm under the U.S. Food & Drug Administration’s Accelerated Approval Program is controversial for a range of reasons, including its projected impact on state Medicaid budgets which will be required to cover the drug, priced at $56,000 a year, despite inconclusive evidence of its clinical effectiveness. 

Commentary

This commentary analyzes how the U.S. Departments of Health & Human Services and Treasury have released a proposed rule governing the Affordable Care Act health insurance marketplaces and insurance standards for the plan year 2022.

Commentary

This commentary tells the story of Ben, born with cerebral palsy, whose Medicaid coverage has helped him access a wheelchair and other essential equipment.

Chart

This chart details the amounts and required oversight of COVID-19 federal funds allocated to hospitals, providers, and states by the Families First Coronavirus Response Act (Families First Act), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the Paycheck Protection Program and Health Care Enhancement Act (HR 266), the Consolidated Appropriations Act, 2021, and the American Rescue Plan Act of 2021.

Commentary

This commentary explains that on June 17 the Supreme Court decisively rejected California v. Texas, the latest lawsuit before the Court that challenged the legality of the Patient Protection and Affordable Care Act of 2010.

Chart

This chart demonstrates how states are using a variety of approaches to provide doula services within their Medicaid programs to address inequities.

Commentary

This commentary tells the story of Silvia, who created a therapy organization in her rural community that provides services to Medicaid populations.

Brief

This brief describes Nevada's new public option that is intended to provide consumers with comprehensive, but lower cost health insurance.

Blog

This blog post highlight's the Virginia Department of Medicaid Services' efforts, successes, and challenges in building a culture of equity.

Commentary

This commentary tells the story of Maddy, who was born with Asperger syndrome and whose Medicaid coverage helps provide transportation to her two part-time jobs.

Podcast

This podcast discusses how People who live in rural areas often experience health disparities caused by barriers to health care, such as lack of transportation, a shortage of providers, and closures of rural hospitals.

Brief

This brief highlights the stories of people with heart conditions who have benefited from Medicaid coverage.

Commentary

This commentary tells the story of Nancy, whose Medicaid coverage allowed her to access mental health care to manage past trauma.

Brief

This issue brief documents how states are collecting information about race, ethnicity, and language on their Medicaid applications.

Commentary

This commentary tells the story of Brook, whose Medicaid coverage helps her provide critical services for her son born with cystic fibrosis.

Commentary

This commentary tells the story of Adrian, who serves as assistant director at a Medicaid-funded program to help youth and families receive critical services.

Commentary

This commentary tells the story of Matthew, who was born with Down syndrome and whose Medicaid coverage helps him to live an independent life.

Brief

This brief highlights the stories of people who have benefited from Medicaid coverage during the COVID-19 pandemic.

Webinar & Presentations

This presentation outlines the key provisions of the Medicaid program.

Report

This report includes a collection of summarized evidence on how Medicaid can improve the health of states' residents and communities.

Commentary

This commentary tells the story of Laticia, who grew up in the foster care system and was able to access Medicaid coverage that helped her get the mental health care she needed.

Commentary

This commentary tells the story of Kerstin, who was born with cerebral palsy and relies on Medicaid coverage for her extensive medical needs.

This journal article describes patterns of perinatal uninsurance and health outcomes of women experiencing uninsurance.

Commentary

This commentary tells the story of Juan, who was born with cerebral palsy and whose Medicaid coverage helps him to work and live an independent life.

Commentary

This commentary tells the story of Matthew, who was born with fetal alcohol syndrome and whose Medicaid coverage has many covered medical and behavioral needs.

Brief

This series of policy briefs include evidence-based recommendations to help people through the immediate health and economic crises and longer-term recommendations to ensure a fair and just opportunity for health.

Commentary

This commentary tells the story of John, whose emergency surgery for a hernia was covered by Medicaid.

Commentary

This commentary tells the story of Robert, who was able to recover from addiction and receive mental health care services through Medicaid.

Commentary

This commentary tells the story of Theresa, who was able to care for her daughter's health needs as she transitioned to a new job.

Commentary

This commentary tells the story of Kaui, whose daughter's complex medical needs were covered by a Medicaid waiver that allowed the family to access a health aide, ventilator, and other essential care services.

Commentary

This commentary tells the story of Michael, who supported his family with Medicaid coverage after 26 years as an educator with employer-sponsored insurance.

Commentary

This commentary tells the story of Jamie, whose daughter was born with a genetic syndrome that led to complex medical needs. Medicaid covers her daughter's health needs so that she is able to continue living at home with her family.

Commentary

This commentary tells the story of Nicole. Nicole has autism, anxiety, and a number of other health challenges, which Medicaid helps her manage so she can work.

Commentary

This commentary tells the story of Maria and her son Tyler. Tyler was diagnosed with Sotos syndrome shortly after his birth, a condition that can result in overgrowth and delayed development.

Commentary

01.2021 / By That's Medicaid

This commentary tells the story of Jessica, a mother who contracted cytomegalovirus which resulted in her daughter Natalie being born with a disability. 

Commentary

This commentary explores the impact of Medicaid expansion during the COVID-19 pandemic and associated job losses.

Commentary

This commentary tells the story of Aliyah. A college graduate and social worker in her mid-20s, spent part of her youth in the Louisiana foster care system, which allowed her to access Medicaid services.

Commentary

This commentary tells the story of Chrystal.  Medicaid was her only option for health coverage when she was a full-time student in Milwaukee, but she was almost denied it when her scholarships and education grants were counted as income.

Commentary

This commentary tells the story of Jessica. While pregnant she contracted cytomegalovirus and it resulted in her daughter Natalie being born with a disability.

Commentary

This commentary tells the story of Maria.  When her son Tyler was diagnosed with Sotos syndrome shortly after his birth, his parents signed up for Medicaid through assistance at the hospital and the program has supported him since.

Commentary

This commentary tells the story of Leah, who runs an organization to help many low-income Medicaid recipients in her community with needed services.

Commentary

This commentary tells the story of Brianna, who signed up for Medicaid in 2016 and was able to receive diagnostic procedures that eventually determined that she suffers from endometriosis and fibromyalgia.

Commentary

This commentary tells the story of Gene. After an accident left him quadriplegic at age 17, Medicaid covers needed help with his daily activities.

Commentary

This commentary tells the story of Estie, whose lifesaving care was covered by Medicaid when her lungs collapsed when she was three months old.

Commentary

This commentary tells the story of Susan, who enrolled in Medicaid after losing her job of 21 years due to the COVID-19 pandemic.

Dataset

This toolkit provides a detailed look at 2020 Medicaid enrollment trends, including enrollment details by state across four eligibility categories.

Commentary

This commentary tells the story of an innovative program in Oregon that provides Medicaid and low-income patients access to healthy produce from local farms.

Commentary

This commentary tells the story of Raevin, whose daughter's medical issues were covered by Medicaid.

Commentary

This commentary tells the story of Milly, whose Medicaid coverage provided the care she needed to get through her breast cancer diagnosis.

Commentary

This commentary tells the story of Latrice, an early learning educator, and her daughter Makayla, who was born with heart complications. Medicaid serves as secondary insurance for the first year of Makayla's life.

Commentary

This commentary tells the story of John, a counselor for a nonprofit AIDS support organization. Medicaid helps cover his HIV medication as well as manage his diabetes, lupus, and heart problems.

Commentary

This commentary tells the story of Susie and her daughter Tymia, who has sickle cell disease. Medicaid covers Tymia's prescription drugs and life-saving surgeries.

Commentary

This commentary tells the story of Kile, who manages his developmental disabilities with the support of services covered by Medicaid.

Commentary

This commentary tells the story of Steve and Erin, whose growing family was covered by Medicaid while Steve studied to become a pastor.

Commentary

This commentary tells the story of Steve, a Kentucky resident whose family was covered by Medicaid as he put himself through seminary school.

Commentary

This report examines Kentucky and Virginia's adapted outreach efforts to help make enrollment as easy as possible to ensure access to critical coverage and care.

Commentary

This commentary tells the story of Linda, a high school teacher whose job does not provide health insurance benefits, and is therefore covered by Medicaid.

Commentary

This commentary tells the story of Jim, who overcomes the challenges of living with cerebral palsy through services covered by Medicaid.

Commentary

Sarah, a Michigan resident with multiple sclerosis, was covered by Medicaid during pregnancy.

Commentary

Noah enrolled in Medicaid in Maryland when he lost his job and health coverage due to the COVID-19 pandemic.

Commentary

Espri is a self-employed farmer whose family is covered by Medicaid in Indiana.

Commentary

This commentary explores how states have been required to make numerous changes to their eligibility and enrollment systems, operations, and policies, in order to comply with the enhanced Federal Medicaid Assistance Percentages.

Commentary

This commentary recommends specific steps for state Medicaid programs to ensure state residents receive needed services during the COVID-19 pandemic, with a specific focus on Medicaid managed care organization (MCO) enrollees.

Journal Article

This journal article focuses on how state-level Medicaid program flexibility and emergency waivers can expand Medicaid financial eligibility for long-term supports and services for at-risk individuals.

Report

This report examines the implications if the outstanding 15 states chose to expand Medicaid eligibility in 2020.

Report

This report uses new enrollment data to examine insurer type enrollment trends from 2016-2018.

Report

This report documents access and affordability challenges facing uninsured new mothers using 2015–18 data from the National Health Interview Survey (NHIS). It also uses 2015–17 data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) to describe the health status of women who lost Medicaid coverage following their pregnancies.

Report

This report shows how the additional levels of unemployment insurance provided through the Federal Pandemic Unemployment Compensation program affects eligibility for subsidized coverage in expansion and nonexpansion states.

Report

This toolkit provides an overview for states of various coverage pathways for individuals, including those who are uninsured, in need of COVID-19 testing and treatment.

Graphic

This infographic highlights what states need to consider when providing pregnancy-related services to Medicaid enrollees through telehealth during the pandemic.

Commentary

This commentary discusses the states that have rapidly amended their Medicaid home- and community-based services for older adults and their family caregivers to ensure access to long-term services and supports during the COVID-19 crisis.

Commentary

Valerie and her husband Christopher wanted to adopt two sons from foster care, both with challenging health conditions, but were not sure if they could afford the medical bills. Valerie learned both children were automatically covered by South Dakota Medicaid because of their time in foster care.

Commentary

April was born with sickle cell anemia, a genetic blood disorder that is deeply painful and must be managed with proper medication. Medicaid covered April’s treatment and her electric wheelchair, which empowers her in her new everyday life.

Commentary

Carolyn was working two jobs without health insurance when she fell in her home and cracked her hip. Unable to afford out-of-pocket expenses, Carolyn received disability coverage through Medicaid.

Commentary

Alecia was born with Down Syndrome, a lifelong condition that comes with physical and developmental challenges. Iowa’s Medicaid coverage empowers her to live independently.

Report

02.2020 / By Urban Institute

This report studies New Hampshire’s Medicaid work requirement program to understand how it was implemented and why it appears to fail to protect coverage and promote work.

Commentary

Paul needed a kidney transplant to save his life, and couldn't have afforded the costs without Medicaid.

Commentary

When Stacia needed treatment for substance use and mental health, Medicaid covered her care.

Commentary

When Sheila's daughter was born with birth defects, Sheila couldn't afford her care. Then she found Medicaid.

Report

09.2019 / By Urban Institute

This report explores what child care challenges parents with Medicaid work requirements may face, and suggests parents may struggle to find care that is affordable, good quality, accessible, and available for nontraditional or unpredictable work schedules.

Report

09.2019 / By Urban Institute

This brief explores state variation in health insurance coverage changes during implementation of the primary health insurance coverage reforms of the Affordable Care Act (ACA) using data from the 2013 and 2017 American Community Survey. 

Commentary

09.2019 / By That's Medicaid

When Jennifer and Jerry welcomed their daughter into the family, Medicaid gave her a healthy start.

Commentary

09.2019 / By That's Medicaid

When Hannah and Martin's son was born, he needed immediate open-heart surgery. Medicaid covered their son’s birth, surgery, and follow-up care.

Webinar & Presentations

This webinar reviewed the Department of Homeland Security's final version of its public charge rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers.

Commentary

09.2019 / By That's Medicaid

Soon after Gail was diagnosed with breast cancer, she lost her job and her health insurance. Medicaid was a lifeline.

Commentary

08.2019 / By That's Medicaid

To stay alive, Bridget must receive dialysis for four hours a day, three times each week. Medicaid is an essential part of her health care coverage, and helps her to lead a normal life.

Commentary

08.2019 / By That's Medicaid

LaVerne was covered by Medicaid while she earned her bachelor's degree in nursing, opening the door for her service in the U.S. Army Nurse Corps.

Report

08.2019 / By Urban Institute

This report shares insights from in-depth interviews with 25 adults in immigrant families who reported that they or a family member avoided participating in safety net programs like Medicaid, SNAP, or housing assistance in 2018 because of immigration concerns.

Commentary

08.2019 / By That's Medicaid

Laura's high-risk pregnancy, and a car accident that left her husband Jed permanently disabled, threw her family's life off course. Learn how Medicaid helped Laura and Jed get it back on track.

Commentary

08.2019 / By That's Medicaid

When Shari's disease worsened, she knew she needed more assistance. Learn how Medicaid helped her maintain her independence, so she could help others in need.

Commentary

07.2019 / By That's Medicaid

Tom was a successful insurance agent with a college degree and a six-figure salary, when personal tragedy sent him spiraling. Learn how Medicaid helped him get back on his feet.

Webinar & Presentations

07.2019 / By Vox

This short video explains what Medicaid expansion is.

Webinar & Presentations

07.2019 / By Vox

This short video explains the difference between Medicaid and Medicare.

Webinar & Presentations

07.2019 / By Vox

This short video explains how Medicaid has expanded its coverage to cover roughly 1 in 5 Americans.

Webinar & Presentations

07.2019 / By Vox

This short video explains the effect of Medicaid on children's health.

Brief

06.2019 / By Urban Institute

This brief examines the prevalence of precarious work schedules among working adults whose families participate in federal safety net programs, using data from the December 2018 Well-Being and Basic Needs Survey.

Report

06.2019 / By Urban Institute

This study assesses potential barriers facing Medicaid enrollees in meeting work requirements through employment on a sustained basis, using pooled data from the September 2018 and March 2019 Health Reform Monitoring Survey.

Report

04.2019 / By Urban Institute

This report explores the effects of Kentucky’s reinstatement of work-related time limits on the SNAP participation of able-bodied adults without dependents between January 2017 and September 2018.

Report

03.2019 / By Manatt Health

This report examines monitoring and evaluation of work/CE demonstrations and reviews the data assets and infrastructure necessary to support states and their researcher partners in robust monitoring and evaluation efforts.

Commentary

In this interview with Louisiana's Medicaid Director Jen Steele, she shares her approach to leveraging Medicaid’s role to improve health outcomes and health equity.

Brief

This brief reviews the role that social and economic factors--such as housing, healthy food, and income--play in a “whole person” approach to health care, especially among Medicaid’s low-income enrollees.

Report

MACPAC's 2018 Medicaid and CHIP Data Book is a collection of federal and state statistics regarding the Medicaid and CHIP programs.

Report

The Department of Homeland Security’s (DHS) proposed rule, Inadmissibility on Public Charge Grounds, proposes significant changes to how it will determine whether an immigrant is likely to become a “public charge” including, for the first time, the use of Medicaid benefits as a key factor in that analysis.This resource answers popular questions about the rule. 

Report

This resource highlights articles published since January 2018 that report on the impact of Medicaid expansion in 33 states and DC, organized by health access and outcomes, economic impacts, and coverage impacts.

Report

10.2018 / By Urban Institute

This report explores changes in coverage type between 2013 and 2016 overall and for key demographic and income subgroups. Between 2013 and 2016, the share of Americans ages 64 and younger without health insurance fell from 17 percent to 10 percent.

Report

09.2018 / By Urban Institute

This report provides detailed estimates of changes in health insurance coverage types between 2013 and 2016 by demographic, socioeconomic, and geographic characteristics. In addition, state fact sheets detail coverage changes by income group in all 50 states and DC.

Report

CMS approved state work/community engagement (CE) waivers in Arkansas, Indiana, Kentucky, and New Hampshire; and additional states have submitted or are poised to submit similar waivers. This series of charts outlines the legal, policy, financial and operational tasks and issues that states will face in adding a work/CE condition to their Medicaid program.

Report

08.2018 / By Urban Institute

This report investigates the work patterns of Medicaid beneficiaries in Kentucky who are are potentially subject to Medicaid work requirements. It finds that the structure of Kentucky’s Medicaid waiver does not seem to align with the reality of some working enrollees’ lives, and that working enrollees losing coverage may not have access to an employer plan.

Webinar & Presentations

This webinar reviews the Stewart v. Azar decision and potential implications for states with approved, pending or planned Medicaid waivers that include work/community engagement requirements. The court’s findings may shape what analysis will be necessary to demonstrate that future waivers advance the Medicaid statute's objectives.

Webinar & Presentations

Webinar discusses the status of state efforts to secure waivers to use federal Medicaid funding to provide care in Institutions for Mental Disease (IMD), including the requirements states must meet to secure an IMD waiver; the status of requests and approvals; and issues and opportunities arising as states pursue and increasingly implement the IMD waiver.

Report

States continue to identify and pursue strategies to further reduce the number of uninsured to make coverage more affordable for consumers and to improve access to care. This issue brief presents two possible models for a Medicaid buy-in program for states, and details the design considerations and authorities needed to implement each model.

Brief

05.2018 / By Urban Institute

An analysis of what would happen if the remaining 19 states that have not expanded Medicaid did so.

Journal Article

05.2018 / By Urban Institute

We assessed rates of employer health insurance offer, take-up, and coverage in June 2013 and March 2017 among workers. Overall, offer rates remained stable, and take-up and coverage rates increased. In Medicaid expansion states, the share of workers with family incomes at or below 138 percent of the federal poverty level who had employer-based coverage held steady, while uninsurance rates declined.

Graphic

This map tracks state Medicaid expansion decisions and approaches states are taking for expanding eligibility to 138 percent of the Federal Poverty Level. It also includes information on state legislative activity around Medicaid expansion, governors’ stances on the issue, and fiscal and demographic analyses from the state or other institutions. For states that are expanding Medicaid, but using an alternative to traditional expansion, the map also contains brief descriptions of these demonstration waivers.

Graphic

In January 2018, the Centers for Medicare & Medicaid Services issued a new policy allowing states to implement work and community engagement requirements for certain Medicaid enrollees. States are permitted to seek federal approval to require non-elderly, non-pregnant, and non-disabled adults to participate in these types of activities to qualify for Medicaid or certain aspects of Medicaid coverage. This chart summarizes states’ pending and approved Section 1115 waivers, waiver renewals, and waiver amendments to implement work and community engagement requirements.

Report

04.2018 / By Urban Institute

In this brief, we provide an overview of the lessons learned from work requirements for Temporary Assistance for Needy Families (TANF, or cash assistance) and Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) and discuss the implications of introducing or expanding work requirements.

Journal Article

This article analyzes the impact of the Affordable Care Act on health insurance coverage for verterans in states that chose to expand Medicaid and in non-expansion states using data from the 2013 and 2014 American Community Survey. The analysis found a substantial 24 percent relative decline in the rate of uninsurance for U.S. veterans between 2013 and 2014. Coverage gains in rural areas were due to gains in Medicaid and individual market coverage. The increase in the insured rate was three times larger in Medicaid expansion states versus non-expansion states.

Report

03.2018 / By Urban Institute

In January 2018, CMS approved Kentucky’s Section 1115 Medicaid demonstration waiver, which allows the state to require some beneficiaries to participate in “community engagement” activities for at least 80 hours a month to retain their Medicaid coverage. This brief revises an earlier analysis on who could be affected by Kentucky’s Medicaid work requirements based on new information posted on Kentucky’s website.

Webinar & Presentations

On January 11, CMS released a State Medicaid Director letter providing guidance for states seeking 1115 waivers that condition Medicaid eligibility on work and community engagement, quickly followed by approval of Kentucky’s 1115 waivers that include these requirements. In this webinar, State Health and Value Strategies and Manatt Health review the new guidance, including key design parameters, budget neutrality requirements, and monitoring and evaluation criteria.

Webinar & Presentations

On January 11, 2018, CMS released guidance for states seeking 1115 waivers that condition Medicaid eligibility on work and community engagement, quickly followed by approval of Kentucky’s 1115 waivers that include these requirements. Both the new guidance and recent waiver approval represent a significant departure from past Administrations’ positions. This webinar reviews the new guidance and discusses state legal, policy, and operational considerations.

Brief

Uncertainty about the future of health insurance options and concern about the ability of Affordable Care Act (ACA) marketplaces to offer adequate competition and choice have spurred states to look for new coverage approaches. Innovative strategies states are proposing include allowing consumers to buy into state Medicaid programs and developing state-specific coverage options within the ACA’s framework.

Webinar & Presentations

This webinar features the Urban Institute's Dr. Fred Blavin, whose SHARE-funded research asks how medical spending burdens for near-poor families in non-expansion states would change if the states were to expand Medicaid.

Brief

CMS has signaled a willingness to evaluate new types of Medicaid proposals from states, such as Medicaid waiver applications that include programs to connect individuals to employment or incorporate features of private market coverage. In response to CMS’ letter, some states have developed proposals that include these types of requirements for certain individuals covered by the Affordable Care Act’s Medicaid expansion—and a few states are seeking similar changes for their non-Medicaid expansion populations.

Report

04.2017 / By Urban Institute

In this report, researchers estimate the impact of the ACA Medicaid expansion on uninsured rates of poor, childless adult citizens, by age, gender, race, income, education, and health.

Brief

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.

Brief

In this brief, we explore two revenue sources states may deploy to fund the non-federal share of expansion: provider assessments and provider donations. Both are authorized by federal law and both have been used by states in connection with expansion.

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