The Congressional Budget Office (CBO), in conjunction with the Joint Committee on Taxation (JCT), issued updated budget projections for fiscal years 2014-2023, which include updated impact estimates of the insurance provisions in the Affordable Care Act (ACA). Slower than anticipated growth in health care spending, particularly in programs such as Medicare and Medicaid, is one of several factors that influenced the revised estimates...

A report recently released by the Robert Wood Johnson Foundation (RWJF) serves as a guide for states considering Medicaid expansion in the wake of the U.S. Supreme Court decision. The analysis in the RWJF report is limited to financial considerations related to a state’s decision to expand and therefore does not include many financial aspects related to the Affordable Care Act (ACA) as a whole (remaining mandatory provisions, for example). There are six main areas of financial analysis that all states should consider that are included in this report: 1. Cost of newly eligibles 2. Cost of currently eligible but not enrolled 3. Administrative costs 4. Savings from transitioning current Medicaid populations to newly eligible group 5. Savings from reduction in state programs for the uninsured 6. Other revenue gains and savings.

In a new report released by the Heritage Foundation, author Drew Gonshorowski suggests that states could be responsible for more than the 10 percent Medicaid match currently called for by 2020 under the Affordable Care Act (ACA). According to the Heritage issue brief, states could face $3.4 billion in new costs if the match rate is reduced to a level that can be called the “blended rate." This is an estimation of what the match rate could be under the Administration’s suggestion. The brief explains, "blended rate is an average of a state’s current Medicaid match, its enhanced match rate for the Children’s Health Insurance Program, and the expansion match rate. The result of this scheme is a drastic reduction in federal spending at the expense of the states."

The Government Accountability Office (GAO) recently released a report on Medicaid expansion under the Affordable Care Act (ACA). The report does not take into account the June 28th United States Supreme Court decision. Congress asked the GAO to report on the actions states are taking to implement the Medicaid expansion. This report addresses the following questions...

Beginning in 2014, the Affordable Care Act (ACA) provides for the expansion of Medicaid eligibility to adults with incomes up to 138% FPL ($15,415 for an individual or $26,344 for a family of three in 2012), which would make millions of currently uninsured adults newly eligible for the program. The Supreme Court ruling maintains the Medicaid expansion, but limits the Secretary’s authority to enforce it—if a state does not implement the expansion, the Secretary can withhold federal ACA expansion funds, but not existing federal program funds. This change in enforcement authority may impact state decisions to implement the expansion. A brief recently released by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured provides an overview of current Medicaid eligibility for adults and data on uninsured adults to provide greater insight into the implications of the ACA Medicaid expansion on coverage for adults across states.

Two new reports, released by the New England Journal of Medicine, analyze the impact of Medicaid expansion under the Affordable Care Act (ACA). "The Supreme Court and the Future of Medicaid," authored by Timothy Stoltzfus Jost and Sara Rosenbaum, reviews both the Supreme Court’s majority and dissenting Medicaid expansion arguments and addresses three outstanding questions regarding the ruling. On June 28th...