Health Reform Hub

Medicaid Expansion

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Status Update: HCBS Implementation May 2015

pdf File May 14th SOTA - HCBS Settings (2).pdf [download]


Status Update: HCBS Implementation May 2015

pdf File May 14th SOTA - HCBS Settings (2).pdf [download]


Proposed Medicaid Expansion in Indiana through HIP 2.0

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In August 2014, Indiana submitted to the Centers for Medicare and Medicaid Services (CMS) a proposal to amend and renew its current its 1115 waiver, "Healthy Indiana Plan." The proposal, which is now open for public comment and subject to CMS approval, seeks to implement the Affordable Care Act's Medicaid expansion in a way that requires waivers of existing federal law.



GAO: HHS's Approval Process for Arkansas Medicaid Expansion Raises Cost Concerns

In approving Arkansas's Medicaid Section 1115 demonstration, the Department of Health and Human Services (HHS) gave the state the authority to test whether providing premium assistance to purchase private coverage offered on the health insurance exchange will improve access to care for individuals newly eligible for Medicaid as a result of the ACA. In this review, the Government Accountability Office found that the "private option" Medicaid expansion may not meet cost neutrality requirements of demonstration waivers.



Community Health Centers: A 2012 Profile and Spotlight on Implications of State Medicaid Expansion Decisions

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In 2012, nearly 1,200 federally funded community health centers were providing access to care for a predominantly low-income population in medically underserved areas across the country. As health insurance coverage expands under the Affordable Care Act (ACA) and the demand for primary care increases, the role of health centers is likely to increase, and the ACA's large investment in the health center program provides new resources to help meet growing needs. This brief provides a pre-ACA snapshot of health centers that can help in understanding the impact of state decisions about the ACA Medicaid expansion on health centers as health reform unfolds in the coming years.



UPDATED: Status of State Action on the Medicaid Expansion Decision

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A central goal of the Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and the Health Insurance Marketplaces. The ACA expands Medicaid coverage for most low-income adults to 138% of the federal poverty level (FPL). Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. This table shows the status of those decisions.



Approved Demonstrations Offer Lessons for States Seeking to Expand Medicaid Through Waivers

New report from CBPP explains the twenty-six states and the District of Columbia that are now implementing health reform's Medicaid expansion. Arkansas, Iowa, and Michigan have expanded through federally approved Medicaid demonstration projects. Waivers provide states additional flexibility in how they operate their Medicaid programs.



Congress and States Work to Extend ACAs Medicaid Primary Care Bump

A blog post from the Georgetown University Health Policy Institute discusses the debate around the extension of the Medicaid payment rate increases for primary care services.



Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid

White House Council of Economic Advisors

This analysis, from the White House Council of Economic Advisers, discusses the economic and health consequences of states' decisions not to expand Medicaid.



'A Uniquely New Hampshire Approach' to Medicaid Expansion

New Hampshire became the 26th state today to embrace the expanded Medicaid program, with as many as 50,000 low-income residents expected to begin signing up. Coverage for those who enroll this month will take effect Aug. 15. Initially, most New Hampshire enrollees will join one of two Medicaid managed care plans in the state. But New Hampshire officials hope that up to 10 percent of those who sign up will eventually enroll in employer plans - using federal money to subsidize that coverage.



Renewing Medicaid and CHIP under the ACA

Georgetown Center for Children and Families

The Affordable Care Act's (ACA) vision for no wrong-door, streamlined enrollment extends to annual renewals. Ultimately, the process should be highly automated with fewer burdens on enrollees to fill out forms or submit paperwork to prove eligibility. However, the first round of renewals will be more involved because eligibility for children, parents, pregnant women, and the expansion adults is now based on new Modified Adjusted Gross Income (MAGI) rules for counting income and household size.



Visualizing Health Policy: Understanding the Effect of Medicaid Expansion in the South

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This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the South remain low; that nearly 80% of the 4.8 million uninsured US adults who fall into the coverage gap live in the South; and that the coverage gap in the South disproportionately affects people of color.



Roadmap to Better Care and a Healthier You

Coverage to Care Project

As part of a health literacy campaign called Coverage to Care, CMS has released this new consumer friendly document which includes 8 steps to help consumers and health care providers be informed about the diverse benefits available through their coverage and how to access care.



State-by-State ACA Fact Sheets

Updated to include FY13 data

HHS has updated its state-by-state Affordable Care Act fact sheets with data through FY13. The fact sheets provide data on the marketplace, Medicaid expansion, mental health coverage, health care workforce, and more.



ACA-Related State Plan Amendments in Medicaid

The Affordable Care Act (ACA) brought significant changes to the Medicaid program, including expanded coverage opportunities for adults under 65 with incomes under 138 percent of the Federal Poverty Level (FPL) and new methodologies for determining and renewing eligibility. States must update their existing Medicaid state plans to implement these changes. These ACA-related State Plan Amendments (SPAs) require states to make important policy decisions which may expand or limit coverage for their Medicaid beneficiaries. This issue brief highlights some of the key state-policy decision points under the SPAs, and provides recommendations for advocates seeking to expand Medicaid eligibility in their states.

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