Expert Perspectives

Oct 30, 2024 

What Do the New Census Data Say About Insurance Coverage for Children and Adults? A Look at Both the National and State Level

The new 2023 estimates from the American Community Survey provide national and state-level insurance coverage estimates, but do not fully reflect the Medicaid unwinding. Despite this limitation, the data are instructive about changes to coverage during the early months of the unwinding period and generally for the year 2023. This expert perspective examines insurance coverage for children and adults, including uninsurance rates for children by state and income level.

Oct 25, 2024 

Resources to Help States Prepare for the Annual Open Enrollment Period

As the 2024 open enrollment period approaches, template social media resources are available to assist states in their outreach efforts. The resources are designed to help states effectively promote important information about Marketplace enrollment and health plan options to consumers, including those who may have lost Medicaid coverage earlier this year.

Oct 18, 2024 

CMS Guidance on Health Coverage Requirements for Children and Youth Enrolled in Medicaid

On September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released comprehensive guidance, accompanied by a summary slide deck, reinforcing and clarifying federal Medicaid requirements regarding Early and Periodic Screening, Diagnostic, and Treatment (EPSDT). This expert perspective provides an overview of CMS’ new EPSDT guidance, which represents CMS’ most comprehensive discussion of EPSDT requirements in over a decade.

Oct 11, 2024 

CMS Offers New Details on Account Transfer 2.0

The Center for Medicaid and CHIP Services (CMCS) explained the transition to “Account Transfer 2.0” (AT 2.0) in a CMCS Informational Bulletin (CIB) released on October 10, 2024. The CIB indicates significant federal investment in improving the process of transferring consumer application information between state Medicaid and CHIP agencies and the Marketplace in the states using the federal platform. This expert perspective reviews the CIB and highlights opportunities for states to improve account transfer data under the CIB.

Oct 11, 2024 

CMS Solicits Comments on Medicaid/CHIP Reporting Templates for Mental Health and Substance Use Disorder Parity

On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.

Sep 27, 2024 

States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits

On April 2, 2024, the Centers for Medicare & Medicaid Services offered a new option for states to update their essential health benefits (EHB) benchmark plan to require coverage of routine adult dental benefits. While there are multiple drivers of inequities in oral health, a primary barrier to accessing dental services is the cost of care, a barrier that can be reduced with dental insurance. This expert perspective provides an overview of the newly available flexibility and discusses considerations for states weighing whether to add a requirement that plans subject to EHB cover routine adult dental care.