Data Points to Consider When Assessing Proposals to Cap Federal Medicaid Funding: A Toolkit for States
Key leaders in Congress and high-ranking members of the Trump Administration are proposing major changes to Medicaid financing through the adoption of a block grant or per capita caps. To assist states in assessing the potential implications of proposals to cap federal Medicaid funding, the State Network team at Manatt Health has developed a toolkit providing state-by-state data on Medicaid enrollment and expenditure trends—factors that are central to establishing the amount each state would be allocated under various capped funding proposals.
Recent proposals for the incoming Congress and presidential administration to repeal the Affordable Care Act (ACA) have also included calls for an overhaul of the current Medicaid program financing structure. Such a change, aimed at reducing federal Medicaid spending, would have significant implications for state Medicaid programs. A new webinar examined these proposals and the potential impact that they could have on states.
Section 1115 waivers allow states to waive certain Medicaid statutory requirements in order to advance state policy priorities and test innovations in their Medicaid programs, provided that they are budget neutral and "further the goals of the Medicaid program." Since 2014, seven states have used 1115 waivers to implement alternative Medicaid expansions, and these waivers are likely to be leveraged by states in the next four years to advance changes to Medicaid. This issue brief, developed by Manatt Health, provides an overview of the features of these alternative Medicaid expansion waivers.
Proposals for the incoming Congress and presidential administration to repeal the Affordable Care Act (ACA) have also included a call for a fundamental overhaul of the Medicaid program by imposing caps on federal funding to states. Such capped funding would replace the central feature of Medicaid's financing structure, the federal government's legal obligation to share all allowable state Medicaid costs. While the design of various proposals to cap federal Medicaid funding may differ in several ways, they all aim to allow the federal government to achieve budget certainty and reduce federal Medicaid spending.
Medicaid expansion under the Affordable Care Act (ACA) has had a positive impact for states, both in terms of the number of people covered and the budget savings and revenue gains that they have realized as a result. A series of recent reports demonstrates the economic impact in states that have expanded Medicaid. A new webinar examined potential repeal of Medicaid expansion under the ACA, and what this would likely mean for states.
Medicaid expansion has generated significant savings and new revenues for states, which they have used to finance spending priorities and to offset state Medicaid costs. States that have expanded Medicaid received over $60 billion in federal funds in 2015 and covered approximately 11 million newly eligible people. This tool, developed by Manatt Health, is designed to help states document the impacts of Medicaid expansion on state budgets, including revenue generation and reductions to state general fund spending on Medicaid and other health related programs and services. This tool can be used to demonstrate the impact of expansion as the incoming administration and the new Congress develop proposals to repeal the Affordable Care Act (ACA), potentially including the Medicaid expansion.
As we approach the beginning of a new presidential administration, there has been continued debate regarding the future of the Affordable Care Act (ACA), much of which has focused on the marketplaces, the mandate, and health insurance reforms such as the ban on insurers' blocking coverage to those with pre-existing conditions. A potential elimination of the law's Medicaid expansion to low-income adults and other ACA Medicaid provisions, however, would have far-reaching implications for states and the Medicaid program.
Using Supplemental Nutrition Assistance Program (SNAP) Information to Facilitate Medicaid Enrollment and Renewal
Recently released CMS guidance and newly established State Plan Amendment authority allows states to use Supplemental Nutrition Assistance Program (SNAP) data, under certain conditions, to enroll and re-determine Medicaid eligibility. In order to assist states in the facilitation of Medicaid enrollment and renewal for eligible SNAP participants, a recent webinar presented some of the necessary considerations for leveraging these data for enrollment purposes.
As evidence of Medicaid expansion’s positive fiscal impact continues to mount across the country, the ability to identify and allocate state general fund dollars “saved” through expansion matters now more than ever. This presentation by Manatt Health reviews the most recent findings on the economic impacts of Medicaid expansion, discusses how state can refine estimates of enrollment, savings, and other expansion impacts, and addresses how states are using information on economic impacts to demonstrate the value of expansion.
With the United States in the midst of a worsening opioid epidemic, an examination of the resources and tools available to states in combating this crisis is critical. With Medicaid serving as the largest source of coverage for behavioral health services, including those related to substance use disorders (SUDs), the role that it can occupy in addressing the epidemic is clear. An additional 1.2 million individuals with SUDs have gained access to coverage in states that have expanded Medicaid under the ACA. This issue brief, developed by Manatt Health, reviews Medicaid strategies to combat the opioid epidemic.