Medicaid & Children's Health: Additional Resources by Date
2006 l 2005 l 2004 l 2003 l 2002 l 2001 l 2000 l more
2006
Illinois' All Kids: A Step in the Right Direction discusses this new children's coverage program, including eligibility, benefits, cost-sharing, and how the program is financed. (October 2006) [Families USA]
The State Children’s Health Insurance Program (SCHIP), created in 1997, has been a major factor in improving health coverage rates for children. Changes in Children’s Health Insurance Status, 1996-2005: Estimates for the U.S. Civilian Noninstitutionalized Population under Age 18 examines trends in children’s health insurance coverage by race/ethnicity and finds that improvements have been particularly dramatic for minority children. (September 2006) [Agency for Healthcare Research and Quality]
The Deficit Reduction Act (DRA) allows states, with federal approval, to move certain groups of Medicaid beneficiaries into “benchmark” plans that do not provide all of the benefits covered by regular Medicaid. The Illusion of Choice: Vulnerable Medicaid Beneficiaries Being Placed in Scaled-Back “Benchmark” Benefit Packages explains that in certain states, groups of vulnerable beneficiaries that were declared exempt from this law—including the elderly, pregnant women, and people with disabilities—are being placed in scaled-back benchmark plans. (September 2006) [Center on Budget and Policy Priorities]
CAHMI has launched the Data Resource Center for Child and Adolescent Health, which provides national, state, and regional data on children’s health care. The site allows users to view state profiles and search the National Survey of Children’s Health and the National Survey of Children with Special Health Care Needs. (September 2006) [Child and Adolescent Health Measurement Initiative (CAHMI)]
SCHIP Enrollees with Special Health Care Needs and Access to Care found that, in general, these children are able to obtain both care from a primary health care provider and routine specialty services. However, state restrictions make it difficult for some children with special health care needs to obtain specialty services. (August 2006) [Child Health Insurance Research Initiative (CHIRI)]
Seeking Solutions: Enhancing Health Care Delivery for People in Connecticut with Limited English Proficiency addresses the state’s increasingly diverse population and the need for culturally and linguistically appropriate health care. The report looks at the cost of providing interpreters for Medicaid recipients with limited English proficiency and the steps states have taken to make this possible. The report is also available in Spanish. (August 2006) [Mathematica Policy Research, Inc. and the Connecticut Health Foundation]
The Deficit Reduction Act of 2005 (DRA) provides states with the authority to impose new premium and cost-sharing requirements on certain groups of Medicaid beneficiaries. The DRA also permits states to substantially redefine and limit covered services and benefits. Role of State Law in Limiting Medicaid Changes provides state-by-state analyses of regulatory requirements for modifying each state’s Medicaid program. The study also investigates how the DRA has affected family planning Medicaid benefits in each state. (revised August 2006) [National Health Law Program and the National Association of Community Health Centers]
Comments from 20 National Organizations on CMS’s Interim Final Rule on the New Medicaid Citizenship Documentation Requirement. (August 11, 2006)
Comments from 80 State and Local Organizations on CMS's Interim Final Rule on the New Medicaid Citizenship Documentation Requirement. (August 11, 2006)
TABOR: A Wolf in Sheep's Clothing examines the effects that so-called "Taxpayer Bill of Rights" (TABOR) state amendments will have on health care. It finds that these anti-consumer conservative initiatives will cripple a state's ability to respond to residents' needs or unforeseen disasters and will result in cuts to essential health care programs, including Medicaid. (August 2006) [Families USA]
Granting states the flexibility to automatically enroll people into Medicaid and SCHIP using information that state officials already have could significantly extend health insurance coverage to uninsured but eligible children and their families, according to Automatically Enrolling Eligible Children and Families into Medicaid and SCHIP: Opportunities, Obstacles, and Options for Federal Policymakers. Unfortunately, legal and technical barriers now prevent auto-enrollment in public health insurance programs. Federal policymakers need to provide states with additional flexibility in determining eligibility and new resources for investing in information technology. (June 2006) [The Commonwealth Fund]
Working-age adults with disabilities need adequate health insurance in order to enter or remain in the work force, but their options for coverage are limited. The Medicaid Buy-In program allows adults with disabilities to earn more than the allowable amount and still have Medicaid coverage. In return, participants “buy into” the Medicaid program, typically by paying premiums based on income. Extending Medicaid to Workers with Disabilities: The Medicaid Buy-In Program examines the participation and success of this program in a series of issue briefs. (June 2006) [Mathematica Policy Research, Inc.]
Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences and Remedies reviews national and state studies and interviews Medicaid and SCHIP administrators, as well as providers and health plan representatives, in four states that have implemented policies to improve coverage. It finds that coverage instability can largely be averted by adopting key policies and procedures, such as limiting the frequency of required renewals; developing easy, seamless transitions between public programs; and setting affordable limits on premiums. (June 2006) [The Commonwealth Fund]
Citizenship Update: Administration Creates Additional Barriers to Medicaid Enrollment addresses several important questions regarding the citizenship documentation requirement for Medicaid under the Deficit Reduction Act (DRA), including what advocates can do to help mitigate the potential harm caused by the requirement. (June 2006) [Families USA]
Vermont's Global Commitment Waiver: Implications for the Medicaid Program provides background information on Vermont's Global Commitment waiver; answers a series of questions about how the waiver program is designed to work; and discusses the waiver's potential implications for Medicaid beneficiaries, the state, and its Medicaid program. (April 2006) [Kaiser Commission on Medicaid and the Uninsured]
With the passage of the Deficit Reduction Act, states can now apply some SCHIP-based principles to their Medicaid programs. Health Coverage For Low-Income Populations: A Comparison of Medicaid and SCHIP examines the similarities and difference between Medicaid and SCHIP, as well as the implications of applying selected SCHIP design features to Medicaid. (April 2006) [Kaiser Family Foundation]
Medicaid’s High Cost Enrollees: How Much Do They Drive Program Spending? analyzes Medicaid spending on a state-by-state basis and finds that less than 5 percent of enrollees account for almost half of total spending. (April 2006) [Kaiser Family Foundation]
Role of State Law in Limiting Medicaid Changes provides an overview of the state laws that are currently in place that limit the ability of state Medicaid agencies to make State Plan Amendments. (April 2006) [National Health Law Program and National Association of Community Health Centers]
Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah: This report is based on a 2004 survey of beneficiaries. The authors’ findings suggest that a coverage expansion approach that relies on savings from reducing coverage for current beneficiaries and provides new coverage solely for primary care has significant limitations. (March 2006) [Health Affairs]
A Case Study of the Utah Primary Care Network Waiver: Insights into its Development, Design, and Implementation examines the creation and implementation of Utah’s waiver through interviews with key stakeholders and an analysis of state enrollment data and quarterly reports. (March 2006) [Kaiser Commission on Medicaid and the Uninsured]
Screening for Medicaid and State Children's Health Program (SCHIP) Eligibility The guide is intended as a reference to help determine whether someone may qualify for Medicaid or SCHIP coverage. Each question includes federal and state-specific information. (Originally published in 2004, updated 2006) [Families USA]
A panel of experts answers questions about how states are working to make health care more accessible during Kaiser's Ask the Experts: State Health Care Initiatives webcast. Topics discussed include prospects for reform in the coming year, approaches states are taking, and the barriers they face. (January 2006) [kaisernetwork.org]
The budget conference agreement passed by the Senate in December and the House in February contains a provision that would require all people applying or reapplying for Medicaid to produce a passport or birth certificate to prove that they are U.S. citizens. The Inspector General of the Department of Health and Human Services has deemed this new requirement unnecessary. New Requirement for Birth Certificates of Passports Could Threaten Medicaid Coverage for Vulnerable Beneficiaries: A State-by-State Analysis estimates that an overwhelming number of applicants would be negatively affected by significant enrollment barriers created by this new requirement. (January 2006) [Center on Budget and Policy Priorities]
California has more than 800,000 uninsured children. The Path to Accessing Health Coverage: Outreach, Enrollment, Retention and Utilization outlines the expansion of public coverage programs, program and system improvements, and the expanding role of the public and private sectors. The report also identifies future challenges and opportunities and puts forth principles to strengthen outreach, enrollment, retention, and utilization in California. (January 2006) [The California Endowment]
In California, many counties and their private partners and funders are refining and expanding their existing outreach and enrollment efforts to more effectively reach a broader range of families. Reaching Out and Reaching In: Understanding Efforts to Identify and Enroll Uninsured Children into Health Insurance Programs provides a review of what is known about the effectiveness of local outreach and enrollment strategies and a framework for ways to evaluate future such efforts. (January 2006) [The California Endowment]
State Medicaid Fact Sheets provide key information for each state's Medicaid program and the population it serves, allowing for easy comparison between states. This tool is continuously updated based on state health data and provides figures and tables that can easily be printed as customized fact sheets. (January 2006) [The Kaiser Commission on Medicaid and the Uninsured]
The Medicaid Benefits: Online Database provides Medicaid benefits survey data from 2003 and 2004, including information about benefits covered, limits, copayments, and reimbursement methods for each of the 50 states, the District of Columbia, and the Territories. Users can search by state or by service, and this tool provides figures and tables that can be easily printed or e-mailed as customized fact sheets. (2006) [The Kaiser Commission on Medicaid and the Uninsured]
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2005
Good for Kids, Good for the Economy: Health Coverage for All Kids in Illinois: A discussion of how Governor Blagojevich's All Kids proposal would expand health coverage for the state's children while helping the economy, bringing federal dollars to the state and generating significant economic activity. (October 2005) [Families USA]
Evaluation of the Local Initiative Rewarding Results Collaborative Demonstrations: Interim Report assesses the first known collaboration created to establish financial incentives for multiple health plans in Medicaid to improve the quality of care for low-income children in California. Although $2.6 million in incentives was paid out to providers by December 2004, the report suggested that not all providers are aware of the incentives program. (August 2005) [Mathematica Policy Research]
Streamlining Children's Eligibility for Medi-Cal Processing: This issue brief identifies a series of issues that the California Department of Health Services, the legislature, and county officials should consider when thinking about ways to improve the eligibility determination process for families. (June 2005) [The California Healthcare Foundation]
Heading into 2004, SCHIP recorded its first-ever decline in enrollment. Ebbing and Flowing: Some Gains, Some Losses as SCHIP Responds to Third Year of Budget Pressure concludes that policymakers are using the flexibility built into Title XXI to cut or expand their SCHIP programs as fiscal conditions permit. The report also explores how child health insurance policies shifted in response to ongoing budget pressures during 2004. (May 2005) [The Urban Institute]
State-Level Impact of Federal Budget Agreement on Medicaid contains tables showing how much money states could lose if Congress adopts its proposed Medicaid cuts, as well as tables showing how many children and seniors could be covered if those cuts weren't made. (Revised May 9, 2005) [Families USA]
On April 11, 2005, Families USA launched the Medicaid: It's Personal Campaign. This campaign bought the focus of the fight back to the people who rely on Medicaid. [Families USA]
Utah's Primary Care Network Medicaid Program provides a summary of the program and discusses the negative impact the program has had on the state's Medicaid program and the people who rely on Medicaid. (April 2005) [Families USA]
Showdown in the Show-Me State: Governor Blunt vs. Medicaid: This report looks at Missouri's proposed severe Medicaid cuts, which would drive the state from the middle of the road to the bottom of the pack in terms of coverage for parents. (March 2005) [Families USA]
The President's Budget Cuts: Loss of Medicaid Coverage Years for Children Includes state-specific numbers (February 17, 2005) [Families USA]
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2004
Capping Medicaid Funding: How Block Grants Would Hurt States discusses how capping federal Medicaid funding and turning the program into a block grant would harm both Medicaid beneficiaries and state budgets. (December 2004) [Families USA]
Tennessee Governor Threatens to End Health Coverage for 430,000 People (November 11, 2004) [Families USA]
The Continuing Medicaid Budget Challenge: State Medicaid Spending Growth and Cost Containment in Fiscal Years 2004 and 2005 is an annual survey of budget conditions and Medicaid cost containment actions in FY2004-05 in all 50 states. It shows that all states implemented Medicaid cost-containment actions in FY2005. The most popular actions were controlling drug costs and reducing or freezing provider payments. (October 2004) [Kaiser Family Foundation]
Beneath the Surface: Barriers Threaten to Slow Progress on Expanding Health Coverage of Children and Families is an annual 50-state survey of enrollment and eligibility policies in Medicaid and SCHIP. It reveals that nearly half of the states (23) took actions that made it more difficult to secure and retain health coverage for children and families. The actions include: freezing enrollment; more stringent enrollment and retention procedures; and increasing premiums or expanding application of premiums to lower-income families. (October 2004) [Kaiser Family Foundation]
Gearing Up: States Face the New Medicare Law: Is Your State Ready for 2006? An Introduction to What the New Medicare Part D Prescription Drug Benefit Means for Medicaid (September 2004) [Families USA]
At least 10 percent of low-income children have serious emotional and behavioral problems. States have adopted widely different ways of financing and delivering children's mental health services. Access to Children's Mental Health Services under Medicaid and SCHIP provides new information on Medicaid and SCHIP coverage of mental health services and on the prevalence of mental health problems among children according to income and health insurance coverage. (August 2004) [The Urban Institute]
Medicaid: Good Medicine for State Economies, 2004 Update: Medicaid provides essential health care services for an estimated 51 million people of all ages and economic classes. Medicaid also plays a unique role in stimulating state economies. This report provides national and state-level data on the effects of Medicaid spending on state business activity, employment, and employee earnings. (May 2004) [Families USA]
Working without a Net: The Health Care Safety Net Still Leaves Millions of Low-Income Workers Uninsured | en español: For millions of low-income Americans, the health care safety net is a myth -- nearly 14 million low-income adults are uninsured and ineligible for public health insurance programs. This Special Report provides national and state-by-state data on the numbers of low-income parents and adults without children who are falling through the holes in our nation's health care safety net. (April 2004) [Families USA]
As the effectiveness of Medicaid's home- and community-based waivers becomes increasingly evident, it's also become clear that Washington should take the lead to help states use the waiver process to serve children with mental health needs. Medicaid Waiver Can Help States Serve Children explains why the waiver process is underused nationally and why access to home- and community-based services for children remains limited. (February 2004) [Bazelon Center for Mental Health Law]
MassHealth, which includes the state's Medicaid program and the State Children's Health Insurance Program (SCHIP), provides health coverage to over 900,000 people representing over 15 percent of state residents. MassHealth Advocacy Guide: An Advocate's Guide to the Massachusetts Medicaid Program provides a thorough description of the program's eligibility requirements, covered services, premiums, and cost-sharing. (2004) [Massachusetts Law Reform Institute]
2003
Driven by flagging revenues and deep budget deficits, states have reduced spending in Medicaid and other health insurance programs by several means, including cutting eligibility, reducing the number of covered health services, and increasing cost-sharing. Losing Out: States Are Cutting 1.2 to 1.6 Million Low-Income People from Medicaid, SCHIP and Other State Health Insurance Programs examines policies implemented in state fiscal year 2003 or 2004 that cause low-income children or adults to lose health coverage. (December 2003) [Center on Budget and Policy Priorities]
The Independence Plus Initiative was established by HHS to give states expanded opportunities within Medicaid to allow for consumer direction of long-term services. This initiative provides beneficiaries with an individual budget to manage personal assistance attendants and a range of other services. An Overview of the Independence Plus Initiative to Promote Consumer-Direction of Services in Medicaid compares core program features with the Cash and Counseling Demonstration program and discusses several policy issues that arise in the implementation of this Initiative. (November 2003) [The Kaiser Commission on Medicaid and the Uninsured]
Policymakers at both the state and federal level have expressed interest in the concept of premium assistance, which entails the use of federal and state funds to subsidize the purchase of employer-sponsored or other private coverage for Medicaid and SCHIP (State Children's Health Insurance Program) beneficiaries. Serving Low-Income Families through Premium Assistance: A Look at Recent State Activity examines new Bush Administration policies associated with using Medicaid and/or SCHIP funds to promote private insurance options, ways that states have responded to these new policies, and key questions that policymakers and others should consider as they think about premium assistance programs. (October 2003) [The Kaiser Commission on Medicaid and the Uninsured]
These two organizations have jointly released a new online database covering Medicaid benefits in all 50 states, the District of Columbia, and the U.S. territories. This comprehensive database includes information about benefits covered by each state; which populations those benefits cover; and the limitations, copayments, and payment rules that apply to the benefits. The database is searchable by Medicaid benefit as well as by state. (October 2003) [The Kaiser Commission on Medicaid and the Uninsured]
While health care access often varies by state, older Americans almost universally lack private or government-sponsored dental coverage. A State of Decay: The Oral Health of Older Americans-An Oral Health America Special Grading Project provides the first state-by-state assessment of the oral health of older Americans, especially those most in need. The report also reviews Medicaid dental coverage for adults in all 50 states and the District of Columbia. (September 2003) [Oral Health America]
State Fiscal Conditions and Health Coverage: An Update on FY2004 and Beyond encompasses three reports on how states are coping with a fourth year of fiscal stress. The reports present the results of the third annual survey of all 50 states, which reveals a far-reaching impact on health coverage for low-income families at a time when enrollment is increasing due to sluggish economic conditions. The reports address such topics as Medicaid spending growth, actions states have taken to control various health care costs, and the falloff in state tax revenue. (September 2003) [The Kaiser Commission on Medicaid and the Uninsured]
Eligibility expansions for low-income children and families under Medicaid and the State Children's Health Insurance Program (SCHIP) have improved access to physicians for many, but problems in this area persist. Access to Physician Services in Public Insurance Programs for Low-Income Populations: A Framework for Assessment and Action organizes what is known about the determinants of physician access into a framework that is intended to help states identify three factors: 1) the sources of problems with physician access, 2) the interventions that may solve these problems (including examples), and 3) the major parties involved in implementing these interventions. (August 2003) [Mathematica Policy Research]
Congress Passes the "SCHIP Fix"! Fact Sheet | Table of State-by-State Estimates (August 7, 2003) [Families USA]
Screening for Medicaid and State Children's Health Insurance Program (SCHIP) Eligibility (July 2003) [The Health Assistance Partnership]
State policies play a critical role in shaping women's access to health care. Women's Access to Care: A State-Level Analysis of Key Health Policies details state activity on a range of polices that affect women's access to care, with an emphasis on private coverage, Medicaid, and reproductive health. Specific policies covered in the report include Medicaid eligibility expansions, managed care protections, and assistance with the costs of prescription drugs. (July 2003) [The Kaiser Family Foundation and the National Women's Law Center]
Children's Insurance Coverage and Service Use Improve presents data showing that the number of uninsured children under age 19 fell from 9.6 to 7.8 million from 1999 to 2002 (an overall drop of 2.6 percentage points). This improvement was concentrated among low-income children: for such children, the rate of those without health coverage fell by almost six percentage points. Over that same period, the number of children covered by Medicaid or SCHIP (the State Children's Health Insurance Program) increased by 4.8 million to 17.4 million. (July 2003) [The Urban Institute]
The National Governors Association Medicaid Block-Grant (June 2003) [Families USA]
Capping Medicaid Funding: The Problem with Block Grants (June 2003) [Families USA]
Tooth decay is one of the most preventable childhood diseases, yet dental care remains the most prevalent unmet health care need for children in the United States. A new Issue Brief, Children's Dental Care Access in Medicaid: The Role of Medical Care Use and Dentist Participation, reports on children's dental care use in the Alabama and Georgia Medicaid programs and strategies for improving access to dental care. Researchers found that less than 40 percent of Medicaid-enrolled children in the study states received dental care, which was typical of other states during the period covered by the study. (June 2003) [The Child Health Insurance Research Initiative (CHIRI)]
While the number of low-income children with health coverage has increased over the past several years due largely to expansions of Medicaid and SCHIP (the State Children's Health Insurance Program), as the economy has weakened, some states have considered proposals that would cut eligibility levels, eliminate outreach, and remove simplification procedures. Maintaining the Gains: The Importance of Preserving Coverage in Medicaid and SCHIP presents evidence of why it is important to maintain these gains and build on them. Substantial research evidence shows that expanding enrollment in Medicaid and SCHIP has important benefits both for the children and families enrolled and for the communities in which they live. (June 2003) [Covering Kids & Families]
Slashing Medicaid: The Hidden Effects of the President's Block-Grant Proposal shows that the President's recent Medicaid proposal, masquerading as fiscal relief for the states, will actually reduce funding for Medicaid and SCHIP by nearly half a trillion dollars over the next 10 years. (May 2003) [Families USA]
Share of Medicaid and SCHIP Funding Paid by the Federal Government, State by State (Rev. May 29, 2003 to reflect changes in tax bill)| By Dollars | By Percents [Families USA]
What a Temporary Increase in Federal Assistance Will Mean for Your State, 2003-2004 (Revised May 16, 2003) [Families USA]
Presumptive Eligibility, from Health Insurance for Children, provides an overview of the use of presumptive eligibility to increase participation in Medicaid and SCHIP. The article discusses the process of determining presumptive eligibility, describes the benefits of the process for children, and examines some concerns that have slowed wider adoption of presumptive eligibility. It also discusses possible solutions that will enable presumptive eligibility to meet its potential to cover eligible children and increase the continuity of their care. (Spring 2003) [The Packard Foundation's Journal, The Future of Children]
How Are States Responding to Fiscal Stress? examines the methods seven states used to balance their budgets during a time of economic difficulty. These states have done little to increase revenue, relying instead on reducing spending by implementing across-the-board cuts or delaying planned program expansions. The report maintains that high matching rates in Medicaid and SCHIP (the State Children's Health Insurance Program) protected these programs to some extent. (March 2003) [The Urban Institute]
Improving the Quality of Medicaid Personal Assistance through Consumer Direction reports on the initial findings from an ongoing evaluation of the Cash and Counseling demonstration project. In the project, participating Medicaid beneficiaries with disabilities are given an allowance and a high degree of flexibility and freedom to choose personal care assistants. The study found that participants in Arkansas who directed their own supportive services were significantly more satisfied and appeared to get better care than those receiving services through home care agencies. (March 2003) [Health Affairs]
Proposed Fiscal Relief to States, FY2003-2004 - How Does Your State Fare? (February 21, 2003) [Families USA]
Issue Brief: Preliminary Analysis of New Bush Proposal to Block-Grant Medicaid (February 12, 2003) [Families USA]
Possible Increase in Federal Share of Medicaid: What Would It Mean for Your State? (February 6, 2003) [Families USA]
Preserving Medicaid in Tough Times: An Action Kit for State Advocates, 2003 Update Designed to help advocates respond state budget cuts and the effects these cuts may have on Medicaid beneficiaries. Kit includes background information, discussion of options, state-based strategies, case studies, and other resources. (January 2003) [Families USA]
Medicaid: Good Medicine for State Economies determines the aggregate impact of Medicaid spending on each state's economy. Using an economic model from the U.S. Department of Commerce, the report calculates the new economic activity that will be generated by Medicaid spending in the following three areas: 1) business activity (the increased output of goods and services); 2) employment (the number of new jobs created); and 3) employee earnings (wages and salaries). (January 2003) [Families USA]
Why Are States' Medicaid Expenditures Rising? cites two reasons for continued increases in Medicaid costs: 1) increases in health care costs for the current caseload; and 2) increases in the costs of caring for beneficiaries who are seniors or who have disabilities. The authors argue that Medicaid costs increases are not a sign that Medicaid spending is out of control but rather are symptomatic of demographic changes and spiraling health costs that are affecting both the private and the public sector. (January 2003) [The Center on Budget and Policy Priorities]
Medicaid Spending Growth: A 50-State Update for Fiscal Year 2003 updates a survey of state officials conducted in June 2002 and aims to reflect the most current information on state Medicaid spending and cost control strategies. The survey was undertaken because it became clear in the fall of 2002 that states' fiscal situations had deteriorated further and states reported that their budget gaps were widening even more. It shows that 49 states have planned or implemented Medicaid cuts in fiscal year 2003, and 32 of them have taken such action twice. (January 2003) [The Kaiser Commission on Medicaid and the Uninsured]
NACHRI, in collaboration with the American Academy of Pediatrics (AAP), has released 2003 updates of their state-specific Medicaid fact sheets. These fact sheets detail the importance of the Medicaid program to the health care of children in every state, as well as the critical role children's hospitals and pediatricians play in serving all children. Click here for a map that will take you to information specific to your state. [National Association of Children's Hospitals and Related Institutions]
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2002
Proposed State Medicaid Cuts Would Jeopardize Health Insurance Coverage for One Million People reports that the state budget deficits projected for fiscal year 2004 represent the largest state deficits in half a century and are at least twice as large as the deficits states faced in the recession of the early 1990s. Because of these budget shortfalls, several states have made major reductions in their Medicaid programs or are considering budget proposals that include deep Medicaid cuts. This report provides brief summaries of actions taken recently or proposals being discussed in 11 states that would lead to the elimination of health coverage for about 1 million low-income people. (December 2002) [The Center on Budget and Policy Priorities]
Five Things Everyone Should Know about SCHIP examines the State Children's Health Insurance Program on its five-year anniversary. The five points discussed are as follows: states have taken advantage of SCHIP's flexibility; SCHIP funds are plentiful to date but may run short; following the enactment of SCHIP, the rate of uninsurance among children has been reduced; SCHIP and Medicaid could cover most uninsured children; and further improvements are needed in both Medicaid and SCHIP. (October 2002) [The Urban Institute]
Medicaid Enrollment in 50 States: December 2001 Data Update provides state-by-state enrollment information and identifies national trends from the data. Among the findings of the report was that the rate of Medicaid enrollment grew by 9.8 percent during 2001, rising by 3.3 million people from December 2000 to December 2001. Enrollment grew by 1.6 million (4.9 percent) for the year ending December 2000 and by 1.1 million (3.5 percent) for the year ending December 1999. (October 2002) [The Kaiser Commission on Medicaid and the Uninsured]
Medicaid Spending Growth: Results from a 2002 Survey reports the results of a survey of Medicaid officials in all 50 states and the District of Columbia. The survey was undertaken to identify state Medicaid spending trends and how states are responding to these trends and to overall fiscal conditions. Among the survey findings are that a majority of states faced significant budget shortfalls this year, and state rainy day funds are being depleted rapidly while tax revenues are falling. (September 2002) [The Kaiser Commission on Medicaid and the Uninsured]
Special Report: Children Losing Health Coverage 900,000 Children in Jeopardy of Losing Health Coverage | Report | Press Release | (September 12, 2002) [Families USA]
States as Innovators in Low-Income Health Coverage examines the extent to which states have been innovative in designing programs to provide health coverage to low-income people beyond what is required for Medicaid and SCHIP. The report begins by discussing the mechanisms available for states to use when expanding coverage. It then divides states into four groups, from most to least innovative, and concludes that most states have not made serious attempts to extend coverage. (June 2002) [The Urban Institute]
Reaching Out: Successful Efforts to Provide Children and Families with Health Care presents a menu of approaches aimed at breaking down barriers to enrolling and retaining "hard-to-reach" populations in Medicaid and SCHIP. It also offers personal stories that exemplify the successes and frustrations such communities face, the public policies that help and hinder their efforts, and policy recommendations geared toward facilitating community-based enrollment in and retention of health coverage. In addition, it includes a list of resources available to community workers and policymakers. (June 2002) [Community Voices]
SCHIP Disenrollment and State Policies presents the results of a study that examined the relationship between disenrollment and state policies in four states that together represented where a third of SCHIP enrollees lived at the time of the study. (June 2002) [The Child Health Insurance Research Initiative (CHIRI)]
Variations among States in Health Insurance Coverage and Medical Expenditures: How Much Is Too Much? attempts to answer this question: How well is our decentralized health care system doing in providing coverage and access to Americans, particularly low-income Americans, regardless of where they live? To that end, it explores the considerable variation in health insurance coverage for children and nonelderly adults. It provides information on private and public coverage, uninsurance rates, and on expenditures on Medicaid and other programs states use to support health services. (June 2002) [The Urban Institute]
Reaching Uninsured Children through Medicaid: If You Build It Right, They Will Come examines what it takes to modernize Medicaid and how modernization has increased enrollment in both Medicaid and SCHIP. The report includes tables that present enrollment figures for all 50 states and D.C., examine the relationship of Medicaid to overall enrollment of children, families, and pregnant women, and list the states that have not simplified their enrollment processes. The authors note that one of the current challenges is "to not let barriers creep back into the system as a hidden cost saving mechanism." (June 2002) [The Kaiser Commission on Medicaid and the Uninsured]
Medicaid-TANF $500 Million De-Linking Fund: This newly revised chart lists the funds allocated to each state for programs that help ensure that people who are eligible for Medicaid are enrolled or remain enrolled in Medicaid. (May 2002) [Families USA]
Enrollment Hits the Web: States Maximize Internet Technology in SCHIP and Medicaid describes how states have used online enrollment in an attempt to reduce enrollment time and increase access for applicants. This Issue Brief describes online enrollment programs in California, Georgia, Pennsylvania, Texas, and Washington. (May 2002) [National Governors Association]
New data finds recent Medicaid enrollment increases in more than half of the 21 states surveyed. A companion report describes survey results on ways states are trying to simplify the enrollment process. (April 2000) [The Kaiser Commission on Medicaid and the Uninsured]
Children's Eligibility for Medicaid and SCHIP: A View from 2000 presents estimates of Medicaid and SCHIP eligibility for children up to age 17 using the eligibility rules in place as of July 2000. The results are based on data from the 1999 National Survey of America's Families. The Survey found that eligibility varied tremendously across states, and the brief includes state-specific data for 13 states: AL, CA, CO, FL, MA, MI, MN, MS, NJ, NY, TX, WA, WI. (March 2002) [The Urban Institute]
Medicaid Cost Containment: A Legislator's Tool Kit, while designed to help state lawmakers ask the right questions when considering whether a given approach is appropriate for their state, may also provide information and insight useful to state advocates. The kit includes a chapter on spending and costs (which points readers to sources of information about state-specific costs and spending and includes summary tables showing which strategies address each of the different factors driving cost increases); a chapter on thinking strategically (which offers advice on how to obtain and analyze state-specific information); and a chapter on 10 cost-cutting strategies that states have used successfully (only one of the strategies was posted on the Web). (March 2002) [National Conference of State Legislatures]
Medicaid and State Budgets: An Overview of Five States' Experiences in 2001 presents a review of the role of Medicaid in the budgets of five states: Idaho, Indiana, Missouri, North Carolina, and Texas. In it, state-level researchers and policy experts from those states describe their state's Medicaid programs and overall fiscal situations, explain recent trends in Medicaid spending, and identify their state's responses to growing fiscal pressure in their Medicaid budgets. (March 2002) [The Kaiser Commission on Medicaid and the Uninsured]
Drug Industry's Deceptive Lobbying at the State Level (March 22, 2002) [Families USA]
Disparities in Eligibility for Public Health Insurance: Children and Adults in 2001 contains charts showing public program eligibility levels in all states for children, parents, and childless adults. (February 2002) [Families USA]
Florida's Medicaid Prescription Drug Benefit: A Case Study focuses on the state's experience with a number of Medicaid prescription drug cost-control measures. Such measures include a 1997 disease management program, the four-brand drug limit imposed in 2000, and the recent passage of S792, which authorized the development of a preferred drug list. Florida's experience is important because other states are looking at it as a potential model. (February 2002) [The Kaiser Family Foundation]
States Strive to Limit Medicaid Expenditures for Prescribed Drugs presents trends in Medicaid spending for prescribed drugs through 2000, summarizes the flexibility states have in designing their drug benefits, and reviews several strategies that states are using to curb their Medicaid drug budgets. The brief also makes the point that the "federal government might be able to save the states-and itself-far more money than various state efforts to control utilization and garner additional rebates simply by deploying the program's leverage to ratchet up federal rebates." (February 2002) [The Kaiser Family Foundation]
The latest edition of The State Children's Health Insurance Program Annual Enrollment Report covers federal fiscal year 2001 (October 1, 2000-September 30, 2001). The report includes enrollment trends by state, eligibility expansions, enrollment trends by program type, enrollment trends by age groups, enrollment of SCHIP parents, and Title XIX Medicaid enrollment. (February 6, 2002) [The Centers for Medicare and Medicaid Services]
State Profiles of Health Insurance, Access, and Use is based on the 1999 National Survey of America's Families and provides basic state- and national-level data in easy-to-use tables. These tables break down the type of health insurance people have according to age, income, sex, race/ethnicity, family structure, family work status, firm size, and country of origin. Separate profiles for each of the 13 states studied (AL, CA, CO, FL, MA, MI, MN, MS, NJ, NY, TX, WA, and WI) also include characteristics of the uninsured, as well as a description of Medicaid and SCHIP enrollees. (January 2002) [The Urban Institute]
State of the States, from the Robert Wood Johnson Foundation's State Coverage Initiatives program, provides an assessment of how budget pressures have forced many states to re-think coverage expansions. The report discusses coverage challenges such as the temptation to cut Medicaid programs, SCHIP enrollment, "SCHIP Dip," and prescription drug costs. It also discusses the impact of the Administration's HIFA waiver initiative, insurance market reforms in 2001, and state planning and demonstration efforts. (January 2002) [The Robert Wood Johnson Foundation's State Coverage Initiatives]
Medicaid: Purchasing Prescription Drugs describes the federal regulatory framework within which states design and implement their Medicaid prescription drug benefits. This Policy Brief summarizes the flexibility available to state Medicaid agencies in designing a prescription drug benefit, controlling utilization, and paying for drugs. It goes on to describe the program under which drug manufacturers provide rebates to both the federal and state governments for the drugs Medicaid buys, and it reviews efforts in Maine and Vermont to extend the discounts achieved by the rebate program to non-Medicaid populations. (January 2002) [The Kaiser Family Foundation]
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2001
Expanding Family Coverage: States' Medicaid Eligibility Policies for Working Families in the Year 2000 reports on the results of a survey undertaken by the Center to better understand the actions states have taken to increase health insurance coverage for parents. Researchers surveyed Medicaid eligibility staff from all 50 states, as well as the District of Columbia, on the Medicaid eligibility rules the states applied to families with children. Generally, the data in this report show that a substantial number of low-income parents lack health insurance, and the authors note that the current recession and state budgetary problems are likely to make it harder for states to address lack of health coverage within their borders. (December 2001) [The Center on Budget and Policy Priorities]
Medicaid Coverage During Times of Rising Unemployment discusses how much an increase in unemployment would be likely to increase Medicaid enrollment and state Medicaid spending. (December 2001) [The Kaiser Family Foundation]
Could Your State Do More to Expand Medicaid Coverage for Seniors and Adults with Disabilities? Expanding Medicaid: State Options provides a detailed discussion of technical aspects of Medicaid expansion for seniors and people with disabilities. (November 2001) [Families USA]
The National Health Law Program (NHeLP) has created a page on their Web site-Waiver Watch-devoted to monitoring Medicaid and SCHIP waiver requests, including HIFA waivers. The first item posted on the site is a link to the waiver request that Washington state recently submitted to CMS. Future postings will include other waiver requests, analyzes of the waiver process in general and of particular waivers, and materials produced by state advocates that may prove useful in analyzing and addressing waiver requests. (November 2001) [The National Health Law Program]
The Kaiser Family Foundation has undertaken a national survey in order to better understand how policy changes at both the state and federal level have altered the financing and delivery of family planning services under Medicaid. Kaiser presents the results of this survey, as well as a discussion of access to such services, in a report titled Medicaid Coverage of Family Planning Services: Results of a National Survey. Among the key findings of the report: "...states vary substantially in the family planning services covered under their Medicaid programs and in the information provided to the program's enrollees about these services." (November 2001) [The Kaiser Family Foundation]
Medicaid has become one of the major funders of prenatal care and delivery services for women in the U.S., but during the 1990's, the Medicaid program changed dramatically with the broad adoption of managed care arrangements for Medicaid beneficiaries. To understand how this shift has changed the way states organize and finance perinatal care, the Kaiser Family Foundation conducted a national survey, and the results of that survey are presented in Medicaid Coverage of Perinatal Services: Results of a National Survey. Among the survey results was that, though most state Medicaid programs cover a comprehensive range of perinatal services, relatively few cover smoking cessation or breastfeeding support services, "two services that can have a dramatic effect and immediate effect on infants' health." (November 2001) [The Kaiser Family Foundation]
Analysis of New Bush Medicaid Policy: This memo analyzes the Health Insurance Flexibility and Accountability Initiative, the Bush administration's new policy regarding Section 1115 Waivers for Medicaid and the State Children's Health Insurance Program (SCHIP). (August 2001) [Families USA]
Health Services Used by Uninsured vs. Insured Children: The Robert Wood Johnson Foundation released the results of a new study in a report titled Survey of American Families: Comparison of Households with Insured Children vs. Uninsured Children Eligible for SCHIP/Medicaid Coverage. The report findings were based on 1,662 interviews of parents with children aged 18 and younger living in the household. Among the findings were that 21 percent of eligible-uninsured children went without needed medical care because their parents could not afford to pay for treatments (compared to three percent of insured children), and that nearly three-quarters of families with eligible-uninsured children do not have access to an employer-provided health plan for children. (August 2001) [The Robert Wood Johnson Foundation]
Final Comments on Revisions to CHIP Regulations: Families USA joins with many other national, state, and local organizations, including child advocates, health advocates, religious groups, and health care providers in responding to the Centers for Medicare and Medicaid Services' revisions to the final regulations for the State Children's Health Insurance Program. (July 2001) [Families USA]
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services: The General Accounting Officehas issued a new report on EPSDT services that states are required to provide children under 21, services that include comprehensive, periodic evaluations of health, developmental, and nutritional status. According to the report, Medicaid: Stronger Efforts Needed to Ensure Children's Access to Health Screening Services, the available evidence indicates many children are not receiving EPSDT services, and state reporting on EPSDT services is "unreliable and incomplete," especially for children in managed care. The report provides examples of innovative state programs. (July 2001) [The General Accounting Office]
Children's Access to Health Care The summer edition of Sign Them Up!, the CHIP newsletter put out by the Children's Defense Fund, focuses on access to health care. More than 23 million children have been enrolled in Medicaid or CHIP, but having health coverage does not mean services can be used. Articles in this edition describe improvements being made in: access to dental services, rural health services, adolescent care, and the renewal process. (Summer 2001) [The Children's Defense Fund]
The National Center for Education in Maternal and Child Health has created "knowledge paths" on several maternal and child health topics. The paths include selections of recent high-quality resources and tools for staying abreast of new developments, including links to Web sites, electronic publications, databases, discussion groups, citations for journal articles, and other print resources. These paths focus on several health-related topics, including "Child Health Insurance and Access to Care," "Children with Special Health Care Needs," and "Racial and Ethnic Disparities in Health." (June-December 2001) [The National Center for Education in Maternal and Child Health]
Restructuring Medicaid Financing: Implications of the NGA Proposal This report analyzes the National Governor's Association proposal to restructure Medicaid, including the financial impact of the core elements of the proposal, considers possible responses to the reforms, and outlines some issues to consider as policymakers think about reforming the program. (June 2001) [The Kaiser Family Foundation]
The Effects of Family Coverage on Childern's Health Status: Powerpoint presentation of a study by Urban Institute researchers Lisa Dubay and Genevieve Kenney, conducted for the Kaiser Commission on Medicaid and the Uninsured. (June 12, 2001) [The Urban Institute]
Moving Beyond CHIP Enrollment: In this report designed for advocates, the Children's Defense Fund emphasizes how important it is for families to enroll their eligible children in a health insurance program before they become sick or injured, as well as the importance of using health services once enrolled. It provides tools for reaching out to families and enrolling children in CHIP and Medicaid, as well as resources for assisting families once they are enrolled. (June 2001) [The Children's Defense Fund]
SCHIP and Crowd Out Has the Jury Reached a Verdict? States' Early Experiences with Crowd Out under SCHIP, a recent report from the Urban Institute, analyzes the experiences of 18 states in implementing policies to limit crowd out. Seventeen of the 18 states in the study adopted policies to address crowd out. The study identified seven types of crowd out strategies, including the use of waiting periods, and the implications of those strategies for enrollment. (June 2001) [The Urban Institute]
Medicaid Managed Care Appeals Process, State Oversight Inconsistent: This report, put out by the Office of Inspector General of the Department of Health and Human Services, summarizes an evaluation of the dispute resolution process for Medicaid beneficiaries enrolled in managed care plans and how well states have implemented federal due process requirements. The Inspector General's office found that, while the dispute resolution systems in the nine states studied appeared to be working as intended, there were still a number of problems: states conduct few managed care hearings, and managed care organizations receive relatively few complaints and grievances; member materials and notices are often inadequate; regulations governing fair hearing timeframes can be ambiguous; states have different interpretations of the plan's role, as well as their own, in fair hearings; and oversight of dispute resolution is inconsistent. (May 2001) [The Department of Health and Human Services]
SCHIP and Children with Special Health Care Needs The Urban Institute has released the results of a new study in a report titled Are We Responding to their Needs? States' Early Experiences Serving Children with Special Health Care Needs under SCHIP. The study, which is based on interviews with government officials, providers, and advocates in 18 states, found that most states did not focus particular attention on children with special health care needs during SCHIP program development. The study also found that none of the states in the study made overt efforts in their SCHIP marketing campaigns to reach out to such children and their families, that states have experienced difficulty identifying and enrolling large numbers of such children into SCHIP programs, and that these children may be affected disproportionately by enrollment waiting periods designed to prevent crowd out. (May 2001) [The Urban Institute]
Presumptive Eligibility for Children in Medicaid and the State Children's Health Insurance Program (CHIP) explains the importance of presumptive eligibility when enrolling children in public programs and looks at how presumptive eligibility works. (May 2001) [Families USA]
Promising Ideas in Children's Health Insurance: Simplifying Eligibility Reviews is the third in a series of reports about innovative ways to offer affordable health care to more children. The report focuses on ways to keep children and their parents enrolled in Medicaid and the State Children's Health Insurance Program (CHIP). (May 2001) [Families USA]
New Urban Institute Findings on Uninsured Children: The Urban Institute has released three new reports as part of their CHIP evaluation. Two of the reports look at parents' reasons for not enrolling their eligible children in Medicaid or CHIP, finding that insufficient knowledge about the programs, confusion about who can enroll in the programs, and administrative hassles associated with enrollment are key reasons. The researchers point out that knowing why families don't enroll their children in Medicaid and CHIP can help inform ongoing outreach efforts. The third report examines how states are dealing with the issue of crowd out, the extent to which crowd out is occurring, and how policies to limit crowd out affect enrollment. All the three studies can be found by following the link below. (May 2001) [The Urban Institute]
Eliminating the Medicaid Asset Test for Families: A Review of State Experiences - A new Kaiser Commission on Medicaid and the Uninsured report reviews the experiences of 9 states and the District of Columbia when they eliminated their Medicaid asset tests for eligibility as of July 2000. (April 2001) [The Kaiser Family Foundation]
Five Good Reasons for States to Expand Family Coverage outlines reasons to expand the Medicaid and SCHIP programs to include working parents and adults. (April 2001) [Families USA]
Sign-on letter to President Bush on immigrant eligibility (February 14, 2001) [Families USA]
CHIP Program Enrollment: June 2000 This Kaiser Family Foundation report reveals that the total number of children enrolled in state CHIP programs had grown to 2.3 million by June 2000, showing a steady increase in enrollment. The report is part of a larger project to track Medicaid and CHIP enrollment in all 50 states. (January 2001) [The Kaiser Commission on Medicaid and the Uninsured]
Medicaid Transportation: A Primer for States, Health Plans, Providers and Advocates can be found at the following web address. (January 2001) [The Urban Institute]
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2000
Charting New Courses for Children's Health Insurance This 18-state study of Title XXI/State Children's Health Insurance Program (SCHIP) implementation strategies, from the Urban Institute's Assessing the New Federalism project, found that distinct trade-offs surround the adoption of either Medicaid or separate program expansions. Medicaid expansions, while simpler to administer, appear burdened by historical links to public welfare. States that created separate programs, while burdened by start-up and coordination challenges, have demonstrated greater innovation in the areas of outreach, enrollment, and service delivery. (December 2000) [The Urban Institute]
Mental Health Benefits Under SCHIP: this state report suggests that states may be better off covering children with serious mental health problems under their Children's Health Insurance Program than under Medicaid. It also estimates the range of costs that could be expected under alternative benefit designs. (November/December 2000) [Health Affairs]
Putting Express Lane Eligibility into Practice: this new guidebook details how the practice of "express lane eligibility," or utilizing information from other public benefit programs, can quicken the enrollment of low-income children into the Medicaid and CHIP programs. The guidebook provides a how-to for states wishing to implement Express Lane Eligibility.(November 2000) [The Kaiser Commission on Medicaid and the Uninsured]
Making it Simple: Medicaid for Children and CHIP Income Eligibility Guidelines and Enrollment Procedures: this report, presents the preliminary findings from a nationwide telephone survey of state Medicaid and CHIP officials. The survey documents current state eligibility rules and enrollment procedures for Medicaid for children and separate CHIP programs, focusing on the extent that states have adopted selected enrollment simplification procedures and the degree to which they have aligned these enrollment strategies in Medicaid and CHIP. The report includes state-by-state tables on selected child health coverage program features for all 50 states and the District of Columbia as well as detailed profiles for 18 states. (October, 2000) [The Kaiser Family Foundation]
Expanding Medicaid coverage to low-income parents reduces number of uninsured children, new research finds. Parental Coverage Also Improves Utilization, Does Not Significantly Erode Employer Insurance. (September 5, 2000) [The Center on Budget and Policy Priorities]
New Guidance: What States Must Do To Delink Their Medicaid and Welfare Programs: The Health Care Financing Administration has released important new guidance to states about what they must do to address a number of problems that have resulted in families inappropriately losing or not accessing their Medicaid coverage as a result of the de-linking of TANF and Medicaid. Families USA summarizes the guidance and provides steps advocates can take to monitor their state's compliance. (June 2000) [Families USA]
Community-Based Research to Promote Comprehensive, High Quality Early Childhood Services: this report, presented at the Professional Development Institute of the National Association for the Education of Young Children, chronicles a Washington DC Head Start parent's harrowing experience with Medicaid Managed Care and describes the affects of Community-based monitoring projects on the participants and on the future of health care services. (June 2000) [The Center on Budget and Policy Priorities]
Conducting Children's Health Insurance Outreach in African American Communities (June 2000) [Center on Budget and Policy Priorities]
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