This issue brief provides a comprehensive look at the EPSDT benefit, including a plan-to-plan comparison with large scale health plans in two states and the Federal Employee Health Benefit Program (FEHBP). That comparison shows that Medicaid’s EPSDT benefit consistently offers more comprehensive coverage for children and greater financial protections for families. It is the gold standard in children’s health coverage.
Health Coverage Matters for Children: The Role of Medicaid in the Healthy Development of America's Children
Access to health care is crucial to children’s health and development. When children have health insurance, they are more likely to get the health care they need. For more than 40 percent of children in the U.S.—approximately 37 million children—Medicaid is the health insurance they rely on. Another 8.9 million children are enrolled in the Children’s Health Insurance Program (CHIP), Medicaid’s sister program. The success of Medicaid and CHIP is largely responsible for the fact that 95 percent of children under 18 have some form of health coverage.
Lowering the price of prescription drugs remains one of the top health care priorities for consumers.1 But pharmaceutical manufacturers continue to increase prices on lifesaving medications.2 A recent proposal from the Trump Administration seeks to control prescription drug costs in Medicaid by giving states the authority to eliminate people’s access to needed and even lifesaving drugs. This approach fails to address the underlying issue of pharmaceutical manufacturers setting such high prices at the national level.
Medicaid managed care contracting is a promising pathway for securing more sustainable funding for community health workers (CHWs). This issue brief provides examples of contract language that can be used to incentivize or require Medicaid managed care organizations to utilize and fund CHWs and considerations for advocates looking to improve support for CHWs through this pathway.
Blueprint for Health Care Advocacy: How Community Health Workers Are Driving Health Equity and Value in New Mexico
Across the health care system, there is tremendous interest and momentum in reforming the way health care is delivered and paid for in order to improve health care quality and outcomes and at the same time, reduce costs. These reform efforts create an enormous opportunity to improve resources, infrastructure, and incentives for interventions to meaningfully reduce racial and ethnic health disparities. Yet, if these reforms are not designed and implemented carefully, they could actually end up making these disparities worse.
Explains what Medicaid Section 1115 waivers are and how advocates can take advantage of new rules that give them a bigger voice in the waiver process.
Several states are still considering expanding their Medicaid programs, and many will use Medicaid waivers for these expansions. This guide tells advocates when and how they can engage in the Medicaid waiver process.
When states don’t extend Medicaid, Americans are hit the hardest. Our brief compares two neighboring states, Missouri and Iowa. Iowa has extended Medicaid coverage, but Missouri has not.
In communities of color, where rates of uninsurance and poor health outcomes are higher than in white communities, the differences between those who have insurance and those who lack it are stark.
We’ve examined data from 22 states showing that working adults make up the majority of those who could benefit if states expanded Medicaid. View our new infographic and issue brief about the top occupations of the working but uninsured residents in Idaho.