Recently, the Centers for Medicare and Medicaid Services (CMS) announced plans to increase the range of Medicaid services furnished by Indian Health Services (IHS) eligible for 100 percent federal match. This proposal, which will effectively reduce states’ costs for Medicaid expansion and buffer the impending decrease in the federal matching rate for newly eligible adults after 2016, may be of particular interest to states with a significant American Indian and Alaskan Native (AI/AN) population.
Medicaid Expansion and Criminal Justice Costs: Pre-Expansion Studies and Emerging Practices Point Toward Opportunities for States
The expansion of Medicaid under the ACA in many states has generated substantial interest in the potential role that Medicaid may play in tackling pressing criminal justice issues. Recent research by Manatt Health Solutions has examined the fiscal implications of Medicaid expansion. This issue brief, the fourth in this series, examines state experiences prior to expansion, focusing on state savings associated with providing health care services and social support to justice-involved individuals through state-funded programs, and also highlights some of the new approaches being adopted by states with Medicaid expansion to connect justice-involved individuals to coverage and care.
Tax year 2014 marked the first year during which all health insurance marketplaces were required to report information about Advance Premium Tax Credits (APTCs) to enrollees through Form 1095-A, which was developed by the Internal Revenue Service (IRS) and used by enrollees to fill out new tax forms. In order to address potential concerns leading up to the execution of this process, the State Network convened a workgroup of states, led by Manatt Health Solutions, which enabled discussion of implementation challenges and solutions. Many of the expected challenges associated with this process were addressed in advance, allowing the marketplaces to provide most forms in a timely fashion and develop solutions to challenges as they arose.
In October, SHVS hosted a webinar on improving care for Medicaid beneficiaries experiencing homelessness, introducing a new issue brief and toolkit for states and featuring presentations by a panel of experts from a state Medicaid agency, a Medicaid managed care plan, and a Medicaid provider – all working to link Medicaid services with housing to improve care for homeless Medicaid beneficiaries.
Nationwide on a given night in January 2014, more than 578,000 people were homeless, and one third of these people were sleeping on the streets, in cars, or other places not meant for human habitation. Over the course of a year, about 1.42 million people used a shelter or transitional housing program for homeless individuals or families. Homeless people often have significant health and behavioral health needs that can be very difficult to manage without stable housing, and many people who experience homelessness are Medicaid beneficiaries. As purchasers of health care, state Medicaid agencies have critical roles to play in the delivery of more appropriate and cost-effective care for people with complex health and behavioral health care needs who experience homelessness.
The State Network 1332 Waivers Affinity Group continued in October with a new presentation from the team at Manatt Health Solutions. This ongoing series has included presentations providing an overview of the basics around these waivers, including statutory guardrails, discussions on what can and cannot be waived, and potential opportunities available to states through the waiver process, while this presentation focused more deeply on potential coordination between 1332 and 1115 waivers, including general guardrails and budget neutrality.
While millions of Americans have newly gained health insurance coverage under the Affordable Care Act (ACA), there is evidence that coverage alone does not necessarily translate into access to health care. This memo, prepared by the State Health Access Data Assistance Center (SHADAC), provides background information on health insurance literacy, summarizes the research around current consumer knowledge, and offers recommendations for marketplaces on how to build on it. Additionally, the State Network has compiled a library of health insurance literacy materials developed by four marketplaces.
Financing Shared Administrative Functions Between State-Based Marketplaces and State Medicaid Programs: Cost Allocation Methodologies
The Affordable Care Act (ACA) provides opportunities for expanded access to health coverage through both the expansion of Medicaid and the establishment of health insurance marketplaces. State-based marketplaces (SBMs), as pathways to both public and private health coverage, are required to perform cross-program functions that support access to both qualified health plans (QHPs) available through the marketplace, as well as coverage through Medicaid. While these shared functions create an opportunity for savings through enhanced efficiency, they also require states to properly attribute funding to both through a process known as cost allocation.
The State Network 1332 Waivers Affinity Group continued with another presentation from the team at Manatt Health Solutions. Following prior presentations providing an overview of the basics around these waivers, including statutory guardrails, a discussion on what can and cannot be waived, and potential opportunities available to states through the waiver process, this presentation investigated more deeply the potential coordination between Section 1332 and Section 1115 waivers.
The State Network 1332 Waivers Affinity Group, hosted by Manatt Health Solutions, continued with a presentation on the process of applying for a 1332 waiver, as well as a discussion on the potential and limitations of these waivers for states relying on the federal marketplace. Previous installments of this webinar series included presentations on the basics of the waiver process and information on statutory guardrails, as well as a deeper analysis of specific examples of what can be waived through this process.