Medicaid

Publications: Medicaid

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Children's Health

Precarious Position: States Must Balance Declining Revenues with a Growing Need for Medicaid Several states are proposing to balance their budgets by cutting Medicaid—raising cost-sharing, shrinking eligibility, or reducing benefits. This issue brief discusses Medicaid cuts in a number of states and recommends congressional action to bring fiscal relief to the states. 12 pp. Free (July 2008)

Five Good Reasons to Increase Health Coverage for Parents discusses the reasons why states should strengthen the health and economic security of families by expanding health coverage for parents. 4 pp. Free (July 2008)

Bad Medicine: The President's Medicaid Regulations Will Weaken State Economies. The Bush Administration issued seven new Medicaid regulations in 2007 that together will strip an estimated $50 billion in federal funds from states over the next five years. These state-specific reports quantify the impact that these changes will have on state economies. 4 pp. Free (April 2008)

Reward/Penalty Plans for Wellness: Coming Soon to an Office Near You? Encouraging healthy lifestyles is important, but might some wellness plans place your access to health care at risk? This piece explores some of the hidden effects that reward/penalty plans for wellness may have on consumers, as well as the problems that these plans might present in both employer-sponsored coverage and Medicaid. 8 pp. Free (January 2008)

Insure Missouri: Too Little, Too Late examines Governor Blunt's proposal to provide health coverage to uninsured Missourians. It finds that the plan's eligibility criteria leave out many low-income uninsured adults, the coverage offered is missing key benefits, the cost-sharing is too high, and the plan is built on shaky financing mechanisms. 10 pp. Free (January 2008)

Healthy Maryland: A Building Block for Maryland's Economy examines the Healthy Maryland Initiative, which will boost the state's economy and extend coverage to more than 100,000 Marylanders who are currently uninsured. 10 pp. Free (October 2007)

The Medicaid Citizenship Documentation Requirement One Year Later examines the citizenship documentation law, including changes that have been made since its implementation in July 2006, as well as its impact on states, Medicaid applicants, and Medicaid enrollees. The issue brief also discusses potential improvements to the requirement contained in the CHIP reauthorization legislation. 8 pp. Free (September 2007)

Kids Waiting for Coverage: How Many Are in Your State? provides national and state-by-state estimates of the numbers of uninsured children who could be covered under the House and Senate CHIP reauthorization bills, as well as a discussion of how successful CHIP has been since its enactment in 1997. 16 pp. Free (September 2007)

Screening for Medicaid and State Children's Health Program (SCHIP) Eligibility is intended as a reference to help determine whether someone may qualify for Medicaid or SCHIP coverage. Each question includes federal and state-specific information. (Families USA, originally published in 2004, updated 2007)

Best Practices: How States Can Reduce the Burden of the Citizenship Documentation Requirement reports on the results of a nationwide survey regarding how states are implementing the DRA. 12 pp. Free (May 2007)

Unwilling Volunteers: Tennesseans Forced Out of Health Care. Tennessee should serve as a cautionary tale for what can happen when a state tries to reduce the cost of programs that provide health coverage to its residents. Personal stories and photographs of Tennessee's unwilling voluteers. 80 pp. $15.00 (April 2007)

Using Blunt Force on Missouri's Most Vulnerable Population analyzes the damage that could be done by SB 577, a proposal to replace the state's Medicaid program. 10 pp. Free (March 2007)

Health Opportunity Accounts: What Are They, and Why Should State Advocates Care? explains what health opportunity accounts (HOAs) are, how they operate, and who can and cannot participate in them. It also discusses why advocates should be concerned about this sweeping provision of the DRA. 9 pp. Free (March 2007)

SCHIP and Children's Health Coverage: Leveling the Playing Field for Minority Children examines the important role that SCHIP plays in reducing disparities in access to care, as well as how the SCHIP reauthorization process can be used to further this effort. 4 pp. Free (December 2006)

Vermont's Health Reform Laws discusses the basics of the state's two new laws, known as "Catamount Health." The piece also examines how Catamount Health will be financed, how the laws build on existing health coverage programs, and pros and cons of the laws. 6 pp. Free (December 2006)

SCHIP 101: What Is the State Children's Health Insurance Program, and How Does It Work? explains the basics about SCHIP, including who qualifies for SCHIP, how SCHIP is financed, and whether eligible are children getting enrolled. 4 pp. Free (November 2006)

SCHIP and Children's Health Coverage: Fitting the Pieces Together examines where children, including low-income children, get their health coverage, as well as how SCHIP and Medicaid have reduced the number of uninsured children. 4 pp. Free (November 2006)

TABOR: A Wolf in Sheep's Clothing examines the effects that so-called "Taxpayer Bill of Rights" (TABOR) state amendments will have on health care. It finds that these anti-consumer conservative initiatives will cripple a state's ability to respond to residents' needs or unforeseen disasters and will result in cuts to essential health care programs, including Medicaid. 6 pp. Free (August 2006)

New Medicaid Regulations Discriminate against U.S.-Born Children of Immigrants focuses on a specific provision of the Deficit Reduction Act (DRA), which has established regulations for citizenship documentation requirements for Medicaid. This provision creates an arbitrary and harmful distinction between children who are born in the U.S. to immigrants versus those born to citizens. 4 pp. Free (August 2006)

The Burden of Proof: New Regulations Worsen Citizenship Documentation Requirement in Medicaid examines the likely consequences of the new Medicaid citizenship documentation regulations and advises advocates on how to mitigate the harm these requirements may cause. 11 pp. (July 2006)

Analysis of the Medicaid Citizenship Documentation Regulations discusses the interim final regulations that the Department of Health and Human Services (HHS) issued in July. The regulations alleviated the burden of documenting citizenship for several important groups of Medicaid beneficiaries and applicants. However, there are still many areas of concern in the new regulations, and millions of eligible Americans will have their coverage delayed or denied because of these onerous requirements. 8 pp. (July 2006)

Citizenship Update: Administration Creates Additional Barriers to Medicaid Enrollment addresses several important questions regarding the citizenship documentation requirement for Medicaid under the Deficit Reduction Act (DRA), including what advocates can do to help mitigate the potential harm caused by the requirement. 11 pp. Free (June 2006)

Cost-Sharing and Premiums: Shifting Costs to Those Who Can Afford It Least explains the new premium and cost-sharing options of the so-called Deficit Reduction Act (DRA) and offers strategies for advocates whose states choose to make changes that could harm people on Medicaid. 8 pp. Free (May 2006)

Medicaid Benefit Package Changes: Coming to a State Near You? explains the changes that states can choose to make in their Medicaid benefit packages as a result of the so-called Deficit Reduction Act (DRA), as well as the harm that might come from implementing such changes. 8 pp. Free (March 2006)

President Bush's Fiscal Year 2007 Budget: Analysis of Key Health Care Provisions Includes discussion and commentary on Health Savings Accounts (HSAs), Medicaid, and Medicare. 13pp. (February 22, 2006)

Millions Must Now Prove Citizenship to Keep Medicaid Coverage explains the implications of this provision of the so-called Deficit Reduction Act (DRA) and outlines steps advocates can take to mitigate the negative consequences of this new requirement. 8 pp. Free (February 2006)

Overview: Medicaid and the Deficit Reduction Act 101 discusses highlights of the new law. It divides the law's provisions into two sections: changes that make it harder to get onto Medicaid, and changes that make it harder for people on Medicaid to get services. 6 pp. Free (February 2006)

Reforming" Medicaid: How State Waivers Will Hurt Racial and Ethnic Minorities examines the potentially negative impact that recently proposed changes to the South Carolina and Florida Medicaid programs will have on minority health. This issue brief also explores the role of Medicaid in improving access to health care for racial and ethnic minorities and analyzes the threat that state Medicaid waivers pose to the health of minority populations. 7 pp. Free (November 2005)

Good for Kids, Good for the Economy: Health Coverage for All Kids in Illinois
A discussion of how Governor Blagojevich's All Kids proposal would expand health coverage for the state's children while helping the economy, bringing federal dollars to the state and generating significant economic activity. 8 pp. Free. (October 2005)

Faced with budget shortfalls and rising Medicaid costs, states are asking the federal government for broad discretion to increase cost-sharing in Medicaid. Cost-Sharing in Medicaid: It's Not about "Skin in the Game"—It's about Lives on the Line discusses how increased cost-sharing deters low-income people from enrolling in coverage and seeking necessary health care, which leads to higher costs in the long run. 4 pp. Free (September 2005)

The Choice: Health Care for People or Drug Industry Profits This report examined drug industry profits and spending patterns to determine if Medicaid payments to drug companies could be reduced without harming either Medicaid enrollees' access to medications or the drug companies' ability to conduct necessary research and development. | Key Findings 36 pp. $15.00 (September 2005)

Gearing Up Series--The Holes in Part D: Gaps in the New Medicare Drug Benefit (Part 1 of 2)
This brief discusses the three major kinds of gaps associated with the Part D benefit: 1) the financial gap beneficiaries will face; 2) the drug coverage gap; and 3) the enrollment gap. 15 pp. Free (July 2005)

Gearing Up Series--Filling the Holes in Part D: The Essential Role of State Pharmacy Assistance Programs (Part 2 of 2)
This brief examines the key decisions states will have to make when determining how their Pharmacy Assistance Programs can provide wraparound coverage and explains the special role of these programs under the Medicare drug law. It also discusses how these programs can help with enrollment. (July 2005)

The Good, the Bad, and the Ugly: Analysis of the National Governors Association's Medicaid Reform Proposal 8 pp. Free (July 2005)

Trouble Brewing? New Medicare Drug Law Puts Low-Income People at Risk
The Medicare Modernization Act (MMA) was touted as a program that would help all Medicare enrollees, particularly the neediest, obtain prescription drug coverage. Now there is evidence that a flaw in the MMA will cause serious harm to many of the most vulnerable elderly and people with disabilities. 8 pp. Free (July 2005)

State-Level Impact of Federal Budget Agreement on Medicaid contains tables showing how much money states could lose if Congress adopts its proposed Medicaid cuts, as well as tables showing how many children and seniors could be covered if those cuts weren't made. 3 pp. (Revised May 9, 2005)

Utah's Primary Care Network Medicaid Program provides a summary of the program and discusses the negative impact the program has had on the state's Medicaid program and the people who rely on Medicaid. 8 pp. (April 2005)

Showdown in the Show-Me State: Governor Blunt vs. Medicaid
This report looks at Missouri's proposed severe Medicaid cuts, which would drive the state from the middle of the road to the bottom of the pack in terms of coverage for parents. 8 pp. Free (March 2005)

Numbers, Numbers, Numbers—One Bottom Line: Huge Medicaid Cuts Proposed discusses the many conflicting numbers proposed for Medicaid cuts and what they really mean for the program. (March 11, 2005)

Cut Medicaid--Increase Health Disparities: How Cuts to "Optional" Beneficiaries Will Affect Minority Health
The lack of true distinction between mandatory and so-called "optional" enrollees. Tthis brief also analyzes how proposed Medicaid cuts that target "optional" enrollees will exacerbate health disparities because they will have a disproportionate impact on the health care and health outcomes of racial and ethnic minorities, particularly African-American seniors in nursing homes. 5 pp. Free (February 9, 2005)

"Capping Medicaid Funding: How Block Grants Would Hurt States discusses how capping federal Medicaid funding and turning the program into a block grant would harm both Medicaid beneficiaries and state budgets. 2 pp. (December 2004)

Medicaid: Good Medicine for State Economies, 2004 Update
Medicaid provides essential health care services for an estimated 51 million people of all ages and economic classes. Medicaid also plays a unique role in stimulating state economies. This report provides national and state-level data on the effects of Medicaid spending on state business activity, employment, and employee earnings. 25 pp. $15.00 (May 2004)

Share of Medicaid and SCHIP Funding Paid by the Federal Government, State by State 2 pp. Free (Rev. March 2004)

Immigrant Provisions of the Senate Prescription Drug Bill: A Good Investment in America's Future discusses the provisions of the Medicare prescription drug bill, which would give states the option of offering Medicaid and SCHIP coverage to children and pregnant women who are legal U.S. residents. (July 14, 2003)

The National Governors Association Medicaid Block-Grant 2 pp. Free (June 2003)

Capping Medicaid Funding: The Problem with Block Grants 2 pp. Free (June 2003)

Slashing Medicaid: The Hidden Effects of the President's Block-Grant Proposal
This special report shows that the President's recent Medicaid proposal, masquerading as fiscal relief for the states, will actually reduce funding for Medicaid and SCHIP by nearly half a trillion dollars over the next 10 years. The report includes year-by-year reductions in spending as well as state-by-state examples of what the most severe reductions (taking place in 2013) would mean--both in terms of dollars and in terms of the impact on people--if they were implemented today. 16 pp. $5.00. (May 2003)

Share of Medicaid and SCHIP Funding Paid by the Federal Government, State by State (Rev. May 29, 2003 to reflect changes in tax bill) 2 pp. Free. By Dollars | By Percents

What a Temporary Increase in Federal Assistance Will Mean for Your State, 2003-2004 4 pp. Free (Revised May 16, 2003)

Proposed Fiscal Relief to States, FY2003-2004—How Does Your State Fare? compares how states would fare under bipartisan fiscal relief legislation introduced in the Senate and the plan offered by President Bush. 4 pp. (February 21, 2003)

Issue Brief: Preliminary Analysis of New Bush Proposal to Block-Grant Medicaid discusses a proposal from the Bush Administration to radically restructure the Medicaid program. The plan would combine Medicaid and SCHIP funds in the form of a federal block grant and would likely result in reduced access to health care for low-income people. 4 pp. (February 12, 2003)

The Bush Administration's Fiscal Year 2004 Budget: Analysis of Key Health Care Provisions
4 pp. Free. (February 7, 2003)

Medicaid: Good Medicine for State Economies
This report determines the aggregate impact of Medicaid spending on each state's economy. Using an economic model from the U.S. Department of Commerce, the report calculates the new economic activity that will be generated by Medicaid spending in the following three areas: 1) business activity (the increased output of goods and services); 2) employment (the number of new jobs created); and 3) employee earnings (wages and salaries). 25 pp. $15.00 (January 2003)

Medicaid: Good Medicine for California's Economy
This report covers the same territory as the national report, but it also includes some additional information. The California report takes recent proposals by Gov. Davis to cut Medicaid spending and uses the economic multipliers to calculate the consequences of those cuts to California's economy. These calculations are done for the governor's December 2002 proposals (see Table 3 in the report) and for his January 10, 2003 proposals. 19 pp. $10.00. (January 2003) Supplemental Table

Preserving Medicaid in Tough Times: An Action Kit for State Advocates, 2003 Update
Designed to help advocates respond state budget cuts and the effects these cuts may have on Medicaid beneficiaries. Kit includes background information, discussion of options, state-based strategies, case studies, and other resources. $20.00 (January 2003)

Medicaid Managed Care Final Regulations Issued
A Field Report. In June, the Bush Administration released final regulations implementing patient protections for Medicaid beneficiaries enrolled in managed care. This report summarizes the main provisions of these regulations, including state plan requirements, enrollee rights, and grievance systems. 11 pp. $3.00 (September 2002)

Expanding Medicaid: State Options - Could Your State Do More to Expand Medicaid for Seniors and Adults with Disabilities? 12 pp. $3.00. (November 2001)

Research Shows the Negative Impact of Out-of-Pocket Costs on Low-Income People summarizes research on the impact of cost-sharing on low-income people. 2 pp. (August 2001)

Consumer Health Assistance Programs: Report on a National Survey
Consumer health assistance programs come in many shapes and sizes. Some serve Medicare beneficiaries, for example; some serve people in long-term care facilities or those who are privately insured. Families USA conducted a nationwide survey of these programs, and the findings are summarized in this report. 48 pp. $15.00 (July 2001)

The Health Care Safety Net: Millions of Low-Income People Left Uninsured.
A Special Report. 8 pp. $2.00. (July 2001)

Designing a Consumer Health Assistance Program
As health care becomes more complex, many states and localities are developing consumer health assistance programs to meet the needs of consumers within their jurisdictions. This guide reviews some key considerations to keep in mind when designing such programs. 24 pp. $15.00. (June 2001)

Medicaid Managed Care Consumer Protection Regulations: No Patients' Rights for the Poor.
A Special Report. 12 pp. $2.00. (May 2001)

Five Good Reasons for States to Expand Family Coverage
This fact sheet outlines reasons to expand the Medicaid and CHIP programs to include working parents and adults. (April, 2001)

Medicaid Managed Care Regulations Issued: What Do They Do? Will They Be Implemented? provides a short history of Medicaid managed care and examines new regulations that will allow states increased flexibility and give beneficiaries new protections. 6 pp. (March 2001)

Immigrants' Eligibility for Medicaid and CHIP 4 pp. Free. (February 2001)

Expanding Coverage for Low-Income Parents: An Action Kit for Advocates
Designed for the busy advocate, this set of materials will help you design and carry out a campaign to expand coverage of low-income parents in your state. Kit includes background pieces, what other states have done, case studies, media strategies, and a PowerPoint presentation on disk. $15.00. (January 2001)

A Guide to Monitoring Medicaid Managed Care
This guide will help community organizations determine how well managed care plans are serving Medicaid beneficiaries. Provides the how-to's of monitoring projects, from simple "do-it-yourself" efforts to the gathering and analysis of data from many sources. 84 pp. $20.00. (September 2000)

Share of Medicaid and SCHIP Funding Paid by the Federal Government, State by State 2 pp. Free (Rev. March 2004)

The National Governors Association Medicaid Block-Grant 2 pp. Free (June 2003)

Capping Medicaid Funding: The Problem with Block Grants 2 pp. Free (June 2003)

Share of Medicaid and SCHIP Funding Paid by the Federal Government, State by State (Rev. May 29, 2003 to reflect changes in tax bill) 2 pp. Free. By Dollars | By Percents

What a Temporary Increase in Federal Assistance Will Mean for Your State, 2003-2004 4 pp. Free (Revised May 16, 2003)

The Bush Administration's Fiscal Year 2004 Budget: Analysis of Key Health Care Provisions
4 pp. Free. (February 7, 2003)

Expanding Medicaid: State Options - Could Your State Do More to Expand Medicaid for Seniors and Adults with Disabilities? 12 pp. $3.00. (November 2001)

Research Shows the Negative Impact of Out-of-Pocket Costs on Low-Income People summarizes research on the impact of cost-sharing on low-income people. 2 pp. (August 2001)

The Health Care Safety Net: Millions of Low-Income People Left Uninsured.
A Special Report. 8 pp. $2.00. (July 2001)

Medicaid Managed Care Consumer Protection Regulations: No Patients' Rights for the Poor.
A Special Report. 12 pp. $2.00. (May 2001)

Five Good Reasons for States to Expand Family Coverage
This fact sheet outlines reasons to expand the Medicaid and CHIP programs to include working parents and adults. (April, 2001)

Immigrants' Eligibility for Medicaid and CHIP 4 pp. Free. (February 2001)

Go to Directly to Work, Do Not Collect Health Insurance: Low Income Parents Lose Medicaid
Nearly one million low-income parents in 15 states lost Medicaid coverage over the past four years, due largely to flaws in state implementation of welfare reform. While states have liberalized eligibility levels so more children can qualify for coverage, few states have done so for parents. 41 pp. $15.00. (June 2000)

Uninsured in Michigan: Working Parents Lose Health Coverage
Parents moving from welfare to work often find low-paying jobs that pay enough to make them ineligible for Medicaid, but do not provide affordable health insurance. This Families USA study found that the number of parents on Michigan's Medicaid rolls dropped 25 percent between January 1996 and December 1999. 15 pp. $5.00. (May 2000)

Clouds Over the Sunshine State: Florida's Working Parents Lose Health Coverage
The number of parents on Florida's Medicaid rolls dropped by more than one-third between January 1996 and December 1999. This Families USA study also found that 41 percent of Florida's lower income adults are uninsured. 21 pp. $5.00. (March 2000)

What Did Welfare Reform Do to Medicaid in Your State and What Can You Do About It: An Action Kit for Advocates
Designed for the busy advocate, this set of materials will help you identify problems in your state's administration of Medicaid and, for each problem, suggests solutions. Profiles of successful organizing efforts in four states, ideas for garnering media coverage, and other resource materials included. $15.00. (January 2000)

Losing Health Insurance: The Unintended Consequences of Welfare Reform
A 45-page report showing that 675,000 people--most of them children--lost Medicaid coverage and became uninsured as a result of welfare reform. The report explains that this troubling trend is likely to accelerate in the years ahead. 45 pp. $15.00. (May 1999)

The Quality of Maryland and District of Columbia Medicaid Managed Care Plans: External Reviews
A 36-page report looks at the external quality review process for Medicaid HMOs and finds problems in how external reviews are administered. December 1998

A Guide to Access to Providers in Medicaid Managed Care
This 62-page guide examines how managed care has affected Medicaid beneficiaries' access to primary care physicians and specialists, including "traditional Medicaid providers." Explores problems in access to care, explains access requirements in federal law, and gives suggestions for steps advocates can take to help assure provider availability. Features tables of provider access requirements in state Medicaid managed care contracts. $20.00. Print only. (April 1998)

A Guide to Meeting the Needs of People with Chronic and Disabling Conditions in Medicaid Managed Care
This 44-page guide, written by National Health Law Program and Families USA, examines issues confronting states as they move toward mandating managed care for people with chronic and disabling conditions. The guide discusses problems experienced when either populations or services are "carved out," looks at steps states have taken to ensure quality care, and provides advocates with information about where to make their voices heard. $20.00. Fact sheet also available. Free. Print only. (January 1998)

A Guide to Complaints, Grievances, and Hearings Under Medicaid Managed Care
This 43-page guide, written by National Health Law Program and Families USA, provides an overview of Medicaid managed care enrollees' legal rights, common problems that prevent beneficiaries from receiving an impartial review, examples of what states have done to protect the rights of beneficiaries, and suggestions for ways advocates can help ensure an adequate complaint process is in place. $20.00. Fact sheet also available. Free. Print only. (January 1998)

A Guide to Cost-Sharing and Low-Income People
This 40-page guide addresses the imposition of cost-sharing (co-payments, deductibles, premiums) in both the Medicaid program and the new State Children's Health Insurance Program. Current legal requirements are presented and research on the effects of cost-sharing is summarized. $20.00. Fact sheet also available. Free. Print only. (October 1997)

A Guide to Marketing and Enrollment In Medicaid Managed Care
This guide reviews common problems experienced when states move their Medicaid populations into managed care and discusses solutions to those problems. Includes a chart comparing provisions of various state RFPs used to solicit enrollment brokers. 34 pp. $20.00. Fact sheet also available. Free. (June 1997)

The Wisconsin Welfare Proposal's Minefield: A Medicaid Block Grant. A Special Report
6 pp. Free. Print only. (June 1996)

The New Republican Medicaid Bill: A Chip Off the Old Block. A Special Report
6 pp. Free. Print only. (April 1996)

What Does the National Governors' Association Proposal Mean for Medicaid Beneficiaries? A Special Report 12 pp. Free. Print only. (April 1996)

Hurting Real People: The Human Impact of Medicaid Cuts
This report focuses on ten key features of the Medicaid program. Describes potential problems families will face if policymakers cut fed-eral Medicaid funds and eliminate federal consumer protections. 36 pp. $5.00. Print only. (June 1995)

Medicaid Cutbacks Harm the States. A Special Report
8 pp. Free. Print only. (March 1995)

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