Much of the story about rising health costs and spending has to do with relatively small groups of people with expensive health needs. For example, the Centers for Medicare and Medicaid Services (CMS) estimates Medicare beneficiaries with two or more chronic conditions accounted for 93 percent of Medicare spending...
The Centers for Medicare and Medicaid Services (CMS) has answered some questions about how Arkansas’s creative plan to expand Medicaid under the Affordable Care Act (ACA). The plan, which Gov. Mike Beebe put forward, would use federal Medicaid expansion money to give premium subsidies for Medicaid beneficiaries to enroll...
Impact of ACA on Health Premiums and Enrollment: Society of Actuaries Estimates of Health Reform LawKip Piper -
Love it or hate it, the Affordable Care Act is unprecedented in size, scope, complexity, and uncertainty. To project its impact, numerous policy, economic, competitive, and behavioral factors must be considered and assumptions made. From an analytical perspective, the ACA is a simultaneous, non-linear equation from hell. A number of...
Kip Piper -
Some states have expressed interest in using premium assistance to expand Medicaid eligibility under the Affordable Care Act (ACA). Instead of serving the new ACA Medicaid expansion population through the Medicaid delivery system (through Medicaid health plans or Medicaid fee-for-service, depending on the state), the new enrollees would be...
Policy circles are abuzz with news about Arkansas Governor Mike Beebe’s creative plan to expand Medicaid under the Affordable Care Act. While details are sketchy and there's no official federal approval yet, the basic idea is to use the federal funding for Medicaid expansion (100% in 2014-2016, no less...
Medicaid Eligibility Streamlining: Modified Adjusted Gross Income Test for Medicaid Eligibility in 2014Kip Piper -
Medicaid eligibility and enrollment is being substantially streamlined. State Medicaid agencies and their contractors are busy adapting eligibility systems and processes to a dramatically new set of federal standards, all required under the Affordable Care Act. Starting in January 2014, the new framework for Medicaid eligibility and enrollment will...
Integrated Care for Medicare-Medicaid Dual Eligibles: CMS Grants for Implementation of State DemonstrationsKip Piper -
To support demonstrations to integrate Medicare and Medicaid for dual eligibles, the Centers for Medicare and Medicaid Services (CMS) offering state Medicaid agencies grants of up to $15 million each. The funds are for implementation of CMS approved designs to integrate care for Medicare-Medicaid enrollees. Most of the state...
Kip Piper -
Much of the nation's long-term care is paid for with Medicaid funding. Medicaid pays 43 percent of all long-term care, while Medicare pays 24 percent and a mix of private health plans and consumers funds the rest, according to the Kaiser Family Foundation. Only half of people who need...
Kip Piper -
In deciding whether to expand Medicaid eligibility under the Affordable Care Act (ACA), governors and state legislatures face a complex, politically and fiscally challenging choice. The decision on Medicaid eligibility expansion is already a hot topic in state capitals and state election campaigns. Expect the politics and policy of...
Kip Piper -
Following a five-year demonstration, a new report examines the Health Opportunity Accounts Demonstration Program created by the Deficit Reduction Act (DRA). The law allowed up to 10 states to test the use of Health Opportunity Accounts as an alternative health benefit design in Medicaid. Participating states were allowed to establish Health Opportunity...
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