Medicaid and CHIP
Posted on November 29, 2013
In a letter sent to State Medicaid Directors, the Centers for Medicare and Medicaid Services (CMS) stated the agemcy would allow states to use “flat files,” or files with very little information about new Medicaid enrollees, to intermittently count as full applications in terms of enrolling individuals into state Medicaid programs under the Affordable Care Act (ACA). The ACA permits states, if they so choose, to expand their Medicaid population, and provides the opportunity for individuals to enroll in Medicaid through the health insurance Exchanges. Currently, the federal government cannot transfer complete Medicaid applications to states, which prevents states from enrolling their constituents into Medicaid in a timely fashion. CMS is addressing this issue by allowing the “flat files” to count as enrollment applications so that states may ensure these new enrollees have Medicaid coverage by January 2014. This fix is a transitional policy, and states must apply for a waiver in order to use the flat files for enrollment.
Posted on October 22, 2013
After the measure to expand Medicaid failed in the Legislature this summer, the Ohio Controlling Board voted 5-2 to approve Medicaid expansion under the Affordable Care Act (ACA). This decision, which will likely be met by a multitude of legal challenges in the coming months, makes Ohio the 25th state to accept enhanced federal funding to help insure the state’s most impoverished residents. Our map has been updated to reflect these changes.
Posted on October 14, 2013
The HealthReformGPS map documenting the current status of Medicaid expansion and Marketplace structure has been updated to reflect the likelihood that Ohio will be the newest state to expand Medicaid under the Affordable Care Act (ACA).
Posted on October 8, 2013
On September 13th, 2013, the Centers for Medicare and Medicaid Services (CMS) issued a final rule concerning the reduction of Medicaid Disproportionate Share Hospital (DSH) payments to hospitals. The reduction methodology discussed in this rule will be effective for FY 2014 and FY 2015…
Posted on October 1, 2013
On September 27th, the Centers for Medicare and Medicaid Services (CMS) issued guidance concerning how same-sex marriages will be treated both in the Affordable Care Act (ACA) health insurance Marketplaces and on Medicaid. This guidance was intended to help facets of the ACA better comply with the June 2013 decision in United States v. Windsor. The letter from CMS concerning health insurance Marketplaces essentially stated that the rules for determining tax subsidy eligibility, including advance premium tax credits and cost sharing reductions, under 36B of the Internal Revenue Code would treat same-sex couples the same as opposite-sex couples. The letter from CMS to State Medicaid Directors provided each individual state with the discretion to adopt their own recognition policy of same-sex marriages, consistent with their own recognition laws, in terms of Medicaid and Children’s Health Insurance Program (CHIP) eligibility. As a result, CMS is encouraging, but not mandating, state Medicaid programs to “recognize same-sex couples who are legally married under the laws of the jurisdiction in which the marriage was celebrated as spouses for purposes of Medicaid and CHIP.”
Posted on September 17, 2013
As full implementation is poised to begin, GPS staff have prepared a map designed to provide a status update in one visual. The map blends Medicaid and Marketplace information to present a more comprehensive view of states’ role in implementation, as the extent of their engagement in two central elements of the law, the Medicaid expansion and the establishment of Marketplaces.
The 16 states in blue are…
Posted on September 4, 2013
On Friday, the Centers for Medicare and Medicaid Services (CMS) released guidance explaining state considerations in designing and executing Medicaid Shared Savings Programs (MSSP). CMS provides flexibility for states in designing MSSP, yet CMS proclaimed they will not partner with state MSSP that only produce cost savings – the program must also improve health care quality and health outcomes. The guidance, in the form of a letter to State Medicaid Directors, does not prescribe a particular model the agency favors, but rather questions states should be able to answer in regards to the design approach they propose.
Update: The IRS’ Final Shared Responsibility Regulations: When Does Medicaid Eligibility Amount to “Minimum Essential Coverage”?
Posted on September 4, 2013
On August 30, 2013, the IRS published final regulations implementing the shared responsibility provisions of the Affordable Care Act (78 Fed. Reg. 53646-53664). The regulations address, among other matters, the complex question of when Medicaid eligibility amounts to minimum essential coverage (MEC) for purposes of the Act’s tax penalties. Because people with MEC are barred from receiving premium and cost sharing assistance for Marketplace plans, the final rules also have important implications in the area of health policy for children and adults with disabilities, who may need both basic insurance and supplemental Medicaid coverage for their more extensive health care needs. Many of Medicaid’s most important disability-related eligibility categories are optional with states and, therefore, monitoring whether and how agency policy on when Medicaid counts as MEC will be an important issue to watch over time.
Posted on August 14, 2013
The Centers for Medicare and Medicaid Services (CMS) has released the Arkansas waiver detailing how the state intends to use federal funding provided to them through the Affordable Care Act (ACA) to enroll their newly eligible Medicaid population into the state’s health insurance Marketplace. This novel approach to Medicaid expansion, known as premium assistance or premium support, received conceptual approval from CMS in March. Implementing this strategy would enable nearly 250,000 Arkansas residents to join Medicaid. The waiver is posted for public comment, and the submission deadline is September 7th, 2013.
Posted on August 1, 2013
A new interactive feature released by the Kaiser Family Foundation indicates how the Affordable Care Act (ACA) may impact Medicaid enrollment and the uninsured demographic at the local community level. The interactive tool is accompanied by a report, as well as other interactive features, that describes how the Medicaid population will change after the ACA is implemented and how the uninsured population will decrease both in and amongst states post-ACA.