Medicaid eligibility

New Methodology Helps Facilitate Medicaid Renewals

When the end of the COVID-19 pandemic led to the end of the moratorium on Medicaid disenrollments, states faced a daunting challenge: how to redetermine eligibility for 90 million people on their Medicaid rolls. The challenge grew even greater when it appeared that significant numbers of people were losing their Medicaid eligibility not because they no longer met the program’s eligibility criteria but for procedural reasons such as inability to gather the information needed to demonstrate eligibility, incomplete applications, or missing application deadlines. To address this problem, the Centers for Medicare & Medicaid Services tried a different approach, working with [...]

joe2025-11-04T16:35:21-05:00November 5, 2025|Centers for Medicare & Medicaid Services, COVID-19, Medicaid|

Federal Health Policy Update for August 21

The following is the latest health policy news from the federal government for August 15-21. Some of the language used below is taken directly from government documents. Congress The House and Senate are in recess and will return to Washington D.C. on September 2. Funding for the federal government expires on September 30, as will a number of health care extenders, including for telehealth flexibilities, the Acute Hospital Care at Home program, the Medicare-dependent hospital and low-volume hospital programs, and delays to Medicaid disproportionate share (Medicaid DSH) allotments. In the fall, Congress is considering pursuing health care legislation along two [...]

joe2025-08-21T14:43:11-04:00August 21, 2025|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare cuts, Medicare reimbursement policy, post-acute care, Telehealth|

The Coming Medicaid Work Requirement

Among the many Medicaid-related aspects of the recently enacted FY 2026 budget reconciliation bill – the One Big Beautiful Bill Act – is a new requirement that much of the Medicaid population be employed or participate in some acceptable form of “community engagement.” But how will the work requirement work? How will it be implemented and enforced? KFF has taken an in-depth look at this matter, reporting on such issues as: What the new law requires. The timeline for the work requirement’s implementation. How much money the states and the federal government stand to save by ending Medicaid How many [...]

joe2025-08-05T17:24:07-04:00August 6, 2025|Congress, Medicaid|

Federal Health Policy Update for May 15

The following is the latest health policy news from the federal government for May 9-15. Some of the language used below is taken directly from government documents. Congress: Reconciliation House Energy and Commerce Committee Charged with finding $880 billion in federal spending cuts over the next ten years, the House Energy and Commerce Committee this week produced legislative language to be included in a House reconciliation bill that would achieve that objective. The committee’s cost-cutting provisions include: Freezing state Medicaid provider taxes at their current level, prohibiting the establishment of new provider taxes, modifying the criteria CMS uses to determine [...]

joe2025-05-15T17:19:56-04:00May 15, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, deficit reduction, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy|

Filling an $880 Billion Medicaid Hole

With the House of Representatives proposing to set a target of reducing Medicaid spending by $880 billion over the next ten years, a reasonable question is “How would states do that?” In a new report, KFF, a non-profit health policy research, polling, and news organization, evaluates the options for how states might respond to such cuts. In its analysis, KFF evaluates how significantly $880 billion in Medicaid cuts might affect states’ budgets and then turns to the question of how states might offset those lost federal funds. Among the options it evaluates are: increasing taxes to raise some or all [...]

joe2025-04-03T16:48:24-04:00April 7, 2025|Medicaid|

Five Million Could Lose Medicaid With Federal Work Requirement

If adopted, a federal requirement that Medicaid beneficiaries in expansion states work at least 80 hours a month to retain their eligibility for Medicaid could result in five million people losing their Medicaid coverage, according to a new analysis. And if that requirement were to be expanded to all Medicaid beneficiaries, that number could rise to as many as 30 million people. The analysis, included in a report released by the Robert Wood Johnson Foundation and the Urban Institute, concluded that: Between 4.6 and 5.2 million adults living in states that expanded Medicaid would lose Medicaid coverage next year under [...]

joe2025-03-26T09:46:47-04:00March 26, 2025|Medicaid|

State-by-State Medicaid Data

New resources published by the Commonwealth Fund share information on the role of Medicaid in serving the U.S. population on a state-by-state basis. The one-page fact sheets – one for each state – share data about how many people in each state are covered by Medicaid or the Children’s Health Insurance Program (CHIP); how many are dually eligible for Medicare and Medicaid; how many adults participate in Medicaid as a result of Affordable Care Act Meedicaid expansion; how much money each state’s Medicaid program receives from the federal government – and the share of each state’s Medicaid spending that federal [...]

joe2025-02-04T14:46:40-05:00February 5, 2025|Affordable Care Act, Congress, Medicaid|

Medicaid Changes on the Agenda?

With a new administration 60 days from taking office and the same party to be controlling the White House, Senate, and House of Representatives, Medicaid changes are a common topic of conversation in Washington policy circles these days. One of the objectives of those conversations: reducing federal spending on Medicaid, which in federal fiscal year 2023 amounted to $860 billion. Among the means of reducing those expenditures that can be expected to be the subject of policy deliberations in the coming months are: Instituting Medicaid work requirements. Ending the supplemental federal Medicaid funding states receive for Medicaid enrollees covered under [...]

joe2024-11-19T16:26:24-05:00November 21, 2024|Affordable Care Act, Medicaid|

Medicaid Enrollment Exceeds Pre-Pandemic Levels

While 25 million Americans have lost their Medicaid eligibility as a result of the post-pandemic “Medicaid unwinding” process, enrollment in the program today exceeds its pre-COVID level. Currently, Medicaid enrollment nationwide is 10 million more than it was in February of 2020, right before COVID struck. In all, 56 million people have had their Medicaid eligibility renewed while 25 million people were removed from the program’s rolls. The current situation varies from state to state; some states have seen enrollment rise while others have experienced enrollment declines. In some states, the status of enrollment gains and losses differs between adults [...]

joe2024-09-25T12:51:45-04:00September 26, 2024|Medicaid|

Federal Health Policy Update for August 22

The following is the latest health policy news from the federal government for August 16-22. Some of the language used below is taken directly from government documents. The Courts The federal government must include uninsured patients whom hospitals serve under state Medicaid waivers when calculating hospitals’ Medicare DSH payments, a federal court has ruled. In the case of Baylor All Saints Medical Center, et al. v. Xavier Becerra, federal policymakers had invoked a 2023 regulation that excluded counting care provided to patients served by DSH-eligible hospitals providing care through state Medicaid waivers – generally, through uncompensated care pools. A group [...]

joe2024-08-22T15:11:48-04:00August 22, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, Telehealth|