Issue Briefs , Reports | Mar 22, 2016

Provider Donations and Assessments: Options for Funding State Costs of Medicaid Expansion

Deborah Bachrach and Anne Karl, Manatt Health

Provider assessments, fees, and taxes are tools available to states to generate funds to cover the non-federal share of Medicaid payments.  This issue brief, developed by the State Network team at Manatt Health, examines two revenue sources that states may utilize to fund the non-federal share of Medicaid expansion: provider assessments and provider donations.  Both of these are authorized by federal law and have been used by states in connection with Medicaid expansion.  The issue brief summarizes the rules regarding their use and describes the ways in which they have been utilized in several states.  This report is part of an ongoing series of issue briefs examining the fiscal implications of Medicaid expansion.  Other installments in this series have analyzed the budget savings and revenue gains realized in expansion states, as well as issue briefs investigating the impact of expansion on uncompensated care and criminal justice-related costs.


Expert Perspectives

September 6, 2024

Current Considerations for State Reinsurance Programs

Reinsurance is a long-standing tool for stabilizing health insurance markets and reducing premiums, and has played an important role in the success of the Affordable Care Act’s individual market as part of section 1332 state innovation waivers. Reinsurance increases affordability for consumers ineligible for the premium tax credit (PTC). However, the effects on PTC recipients are smaller, mixed, and have received little attention. This expert perspective summarizes recent research which raises questions about the impact of reinsurance programs on PTC recipients, and highlights related considerations for state policymakers.

CMS Issues Guidance on Renewal Timeliness Post-Unwinding

On August 29, 2024, the Centers for Medicare & Medicaid Services (CMS) released a CMCS Informational Bulletin (CIB) and accompanying slide deck to support states facing renewal backlogs. With this guidance, CMS is providing states additional time—until December 31, 2025—to complete Medicaid and CHIP eligibility renewals, address persistent backlogs in processing redeterminations, and achieve compliance with federal renewal timeliness requirements. This expert perspective provides an overview of the CIB.