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state-action

After South Dakota voters elected to expand Medicaid eligibility, attention now turns to the 11 states that have yet to expand the program.

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policy

The House voted 220–213 to pass the $1.75 trillion Build Back Better Act. It contains essential hospital priorities related to Medicaid, maternal health, and the health care workforce but also includes harmful cuts to Medicaid disproportionate share hospital and uncompensated care pool payments.

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policy

President Joe Biden last week announced a $1.75 trillion framework for "human infrastructure" reconciliation legislation; the House subsequently released updated legislative text for its human infrastructure bill that aims to close the Medicaid coverage gap.

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policy

The $1.9 trillion package temporarily increases Medicaid disproportionate share hospital allotments to ensure essential hospitals receive the same level of payments as they would have expected absent the pandemic. The package returns to the House for a final vote, expected as early as Tuesday.

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state-action

Illinois is the first state to extend Medicaid coverage to low-income residents ages 65 and older, regardless of immigration status, due to the COVID-19 public health crisis. Meanwhile, Pennsylvania heightened security measures to protect staff and providers against the spread of COVID-19.

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state-action

Several states, including Missouri and Oklahoma, will vote this year on whether to expand Medicaid. However, the topic of expansion will remain unaddressed in several states this year; for example, plans to include expansion on the 2020 ballot in Florida now have been pushed to 2022.

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state-action

This State Policy Snapshot summarizes how states are turning to emergency Medicaid authority to provide coverage of COVID-19 services for specific populations, such as individuals who would qualify for public assistance if not for their immigration status.

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state-action

Under the proposed Section 1115 waiver, Oklahoma would accept a per-capita cap on federal funds for the Medicaid expansion population and incorporate other market-based reforms.

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policy

This decision is the latest of several court cases invalidating work requirements policies in Medicaid; Utah now is the only state with these requirements in effect. It is unknown at this time if Michigan or the Department of Health and Human Services will appeal the decision.

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policy

In the unanimous decision, the United States Court of Appeals for the District of Columbia Circuit found that the Department of Health and Human Services failed to adequately assess the potential impact of work requirements on coverage under Arkansas' Section 1115 demonstration waiver.

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policy

CMS issued guidance outlining how states can receive a block grant or per-capita cap in exchange for additional administrative flexibility. Through a Section 1115 demonstration waiver, these new financing arrangements would apply to coverage of optional Medicaid patient populations.

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state-action

States that expanded Medicaid under the Affordable Care Act saw higher prescribing rates for medication-assisted treatment than nonexpansion states.

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Essential Insights

Essential hospitals are an important resource to help patients determine their eligibility for Medicaid and other assistance programs.

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state-action

Proponents are collecting voter signatures in Florida, Missouri, and Oklahoma for 2020 ballot initiatives to expand Medicaid.

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institute

The retrospective study used AHRQ Healthcare Cost and Utilization Project data from 2011 to 2015 to estimate the effects of Medicaid coverage expansion on hospital utilization rates, costs, and patient illness severity.

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state-action

The expansion, which takes effect in 2020, applies to low-income residents ages 19 to 25, regardless of immigration status. The state estimates more than 100,000 undocumented young adults will be eligible for the expanded coverage.

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Essential Insights

Decisions made at the state and federal levels regarding Medicaid expansion continue to evolve nearly a decade after passage of the Affordable Care Act.

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policy

Utah joins a growing list of states with approval to implement Medicaid work requirements, but it is the first state to limit enrollment to individuals below the federal poverty level and implement a spending cap.

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policy

The tools and guidance aim to help states monitor and evaluate the effects of Section 1115 waiver demonstrations, including those with work and community engagement requirements and those that combat substance use disorder.

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policy

Ohio’s waiver requires beneficiaries ages 18 to 49 who are eligible through Medicaid expansion to work or participate in other community engagement activities for at least 80 hours a month.

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policy

The president's fiscal year 2020 budget plan calls on Congress to significantly reform the two programs, including ending Medicaid expansion and changing Medicare uncompensated care payments.

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policy

The waiver requires beneficiaries ages 19 to 49 who are eligible through Medicaid expansion to work or participate in community engagement activities for at least 80 hours a month.

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policy

Maine and Michigan join five other states to receive approval for Medicaid work requirements; unlike most other states, Maine's work requirements will apply to both existing beneficiaries and those newly eligible through expansion.

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state-action

Three new Democratic governors have vowed to move forward with Medicaid expansion in their states; Meanwhile, voters in Idaho, Nebraska, and Utah approved Medicaid expansion, while Montana voters rejected an initiative to extend the state's expansion past June 2019.

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policy

Wisconsin is the fifth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

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policy

The expansion is expected to give up to 400,000 additional Virginians access to the program; the Centers for Medicare & Medicaid Services has not announced a decision on the state's Section 1115 waiver, which includes work requirements.

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policy

New Hampshire is the fourth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

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policy

Under the approved waiver, Arkansas Medicaid beneficiaries ages 19 to 49 beginning June 1 must work or participate in community engagement activities for 80 hours per month to maintain their eligibility.

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policy

The Centers for Medicare & Medicaid Services approved Indiana's request to incorporate work requirements in their Section 1115 Medicaid expansion waiver. This is the second waiver with work requirements approved by CMS.

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policy

The bill would replace Medicaid expansion funding and private insurance subsidies with $1.2 trillion in block grants to states; the Congressional Budget Office is expected to release a score early next week.

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The proposal appears to significantly restrict federal health care funding through per-capita caps and block grants; shift costs to states, patients, providers, and taxpayers; and achieve the same result as earlier bills: millions left uninsured.

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webinar

Participants learned about the evolution of Medicaid Managed Care and how essential hospitals can succeed in the changing environment from experts at Premier Inc.

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policy

Expanded Medicaid access under the Affordable Care Act might have helped patients seek treatment for behavioral health issues, which disproportionately affect low-income populations.

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institute

Researchers examined outcomes in Kentucky, Arkansas, and Texas; they found expanding access to health coverage improved care access and affordability.

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policy

Negotiations continue; areas of contention include the Medicaid per-capita cap growth rate and the phase out of Medicaid expansion enhanced funding.

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policy

The brief projects Medicaid disproportionate share hospital payment reductions under the Affordable Care Act and the House-passed American Health Care Act.

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policy

Senate Republican leaders aim to submit a draft bill to the Congressional Budget Office early this week and vote on the bill before the July Fourth recess.

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policy

The American Health Care Act's Medicaid cuts would fall heavily on low-income states that expanded Medicaid under the Affordable Care Act.

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policy

Samuel Ross, CEO of Bon Secours Baltimore Health System, testified at an event held by House Democrats on the Republican-proposed bill to repeal the ACA.

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policy

The letter affirms their desire to improve the Medicaid program and the vulnerable people it serves and to ensure the program provides value to taxpayers.

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policy

The committees on Energy & Commerce and Ways & Means passed ACA repeal and replacement bills that could affect coverage and essential hospital funding.

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policy

The American Health Care Act offers some relief for the safety net, but the association remains deeply concerned about substantial changes to Medicaid.

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webinar

Attendees heard about the current status of health care legislation, including efforts to repeal and replace the Affordable Care Act.

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policy

A review of 61 studies found that expansion under the ACA has improved health coverage, access to care, and economic outcomes.

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webinar

Sarah Mutinsky will be covering the rules and challenges of financing non-federal Medicaid payments.

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policy

Congress debates omnibus appropriations measure, considers another stop-gap funding bill, as deadline for government shutdown looms.

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policy

Senate plans to expand House reconciliation bill with full ACA repeal; Rep. Brady named Ways and Means chair; Republicans establish Medicaid task force.

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policy

The briefing included a panel of four experts serving different Medicaid populations who spoke about continuing to strengthen the program and the role of Medicaid expansion in increasing access to care.

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institute

Articles focus on innovative waivers that support states in transforming delivery systems to improve access and quality of care. Another focus is Medicaid coverage in areas of crucial need, such as mental health care.

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institute

Articles cover the ACA's Medicaid expansion, Medicaid shortfalls and community benefit funds, and the impact of recent Supreme Court decisions on Medicaid.

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policy

Proposed renewals must be for demonstrations that are working effectively and have no major or complex policy changes. Certain waivers that use the enhanced FMAP are ineligible.

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policy

Research shows how Medicaid coverage improves health and health care outcomes, and saves money.

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policy

CBO also found that if a full ACA repeal took effect on Jan. 1, 2016, the federal deficit would increase by $137 billion between 2016 and 2025.

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webinar

Learn more about how states are negotiating alternative Medicaid expansions.

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policy

America's Essential Hospitals is conducting this member survey to capture the impact of the ACA coverage expansion on essential hospitals.

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policy

Report includes potential impact if CHIP was to expire, Section 1115 waivers used to expand Medicaid coverage, and other aspects of Medicaid payment policy.

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policy

Specifically, HHS will evaluate financial assistance programs, Medicaid expansion, pioneer ACOs, and marketplace payment systems.

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policy

The survey aims to capture the impact of ACA coverage expansion and add to association advocacy efforts with timely information on members' uncompensated care.

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White House report a positive sign, but essential hospitals continue to face significant uncompensated care burden and looming cuts to disproportionate share hospitals payments

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policy

GAO found that HHS did not ensure budget neutrality when approving Arkansas' Medicaid expansion waiver. Issues include lack of data to corroborate state assumptions and state flexibility to expand spending limits.

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policy

Pennsylvania will expand Medicaid through a private option, requiring some enrollees to pay premiums.

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Essential Insights

It is difficult to find creative ways to describe the thoughtlessness of states’ decisions to opt out of Medicaid expansion under the Affordable Care Act. Here is my latest involving a stats website and baseball.

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Essential Insights

Action, engagement, and the human story of often technical or financial issues is key to driving education and awareness - learn how Medicaid expansion became personal.

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Association joins lawmakers in call for non-expansion states to 'do the right thing now' and support vulnerable patients and their hospitals.

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policy

A recent study published by the Kaiser Family Foundation analyzed Medicaid spending growth during the Great Recession. Spending per enrollee grew slower than medical care inflation, national health expenditures per capita, and growth in private health insurance per enrollee.

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policy

The fact sheets assist hospitals and other organizations in community outreach and enrollment efforts. They cover the basics of Medicaid and CHIP benefits, enrollment eligibility, and enrollment processes.

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policy

White House Council of Economic Advisers released a report describing opportunities missed by states that have not expanded Medicaid under the Affordable Care Act.

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White House report confirms the numerous benefits of Medicaid expansion and demonstrates that state decisions not to expand have far-reaching consequences for our nation's health and economy. Essential hospitals have driven enrollment and need continued financial support to serve their communities.

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policy

A recent study found that planned reductions in Medicaid DSH payments and ongoing inflation in health care costs will cause debilitating gaps in funding for essential hospitals. Expected system costs to states that do not expand Medicaid will be exacerbated by continued uncompensated care costs and no additional Medicaid funds to offset them.

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webinar

Government relations staff will share their experiences with Medicaid expansion, including challenges and best practices

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policy

CBO said states will incur $46 billion in Medicaid expansion costs from 2015-2024. This is about one-third less than CBO's February prediction that Medicaid expansion would cost states $70 billion.

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webinar

Learn how delivery system transformation initiatives helped BMC improve quality

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policy

CMS has developed several resources to help hospitals implement presumptive eligibility, including model agreements between the state and hospitals, a model training template for states, a model application for hospitals, and FAQs.

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policy

The final rule establishes procedures for enrollment and certification. CMS also released its final methodology for determining federal payments to states establishing a BHP program in 2015.

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webinar

Government relations experts from essential hospitals shared strategies they have used to move their state toward Medicaid expansion

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policy

The Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act would repeal the Affordable Care Act and replace it with market-based reforms. The plan would keep some ACA provisions. The proposal would end the individual mandate and offer tax credits for individuals unable to afford coverage.

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Calls action "important step toward protecting access to vital health care and community services for millions"

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policy

States expanding their Medicaid programs saw a 15.5 percent increase in applications

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policy

Providers that fill a safety net role will be stretched thin in states that do not expand Medicaid

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policy

Analysis finds program is likely to grow in states expanding their Medicaid program

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policy
policy

Bill would halt subsidies until applicant coverage requirements, household income can be verified

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Says Bloomberg Government report underscores "uncertain and deeply troubling future for vulnerable patients"

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policy

Effort will seek to increase understanding of low-income and minority populations’ experiences with exchanges

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policy

Analysis from the Kaiser Family Foundation Commission on Medicaid and the Uninsured found that 6.4 million people will miss out on insurance coverage if the 21 states not intending to expand their Medicaid program and the six undecided states do not implement the Medicaid expansion.

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policy

Regulation finalizes provisions on how eligibility will be determined and hardship exemption certificates granted

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policy

States that opt out could lose $8.4 billion in federal funding, Health Affairs study finds

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Notes appreciation of one-year DSH cut delay, but says provision comes at expense of funding later

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policy

Agency also releases FAQ on state-supplied premium assistance option

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policy

Lawmakers turn back governor's plan to accept expansion for three years

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policy

Document addresses questions about federal medical assistance percentages

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policy

President and CEO Bruce Siegel moderated sessions on Medicaid, delivery innovations

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policy

Administration official announced that the president would not include Medicaid cuts in 2014 budget

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Says agency guidance follows "letter and spirit of the law" and takes step toward significantly reducing uninsured

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Effort includes short videos, banner ads, and related website of research, position papers, and other resources

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Analysis show impact of Supreme Court decision on hospitals and vulnerable patients

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Estimates show up to 10 million more people will remain uninsured than assumed when ACA passed

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Association says s many as 13.8 million are at risk of going uninsured in non-expansion states

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Decision could "could strand millions of our most disadvantaged people without access to basic health care coverage"

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