Tag Archives: medicaid

CMS expands popular home and community-based program

Photo by SHVETS production via pexels.

The Centers for Medicare and Medicaid is funding five additional states and territories to expand access to home and community-based services through Medicaid’s Money Follows the Person (MFP) demonstration program.

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3 reasons it’s significant that the percentage of uninsured Americans hit an all-time low

Source: National Center for Health Statistics, National Health Interview Survey, 2021–2022. Cohen RA and Cha AE. Health insurance coverage: Early release of quarterly estimates from the National Health Interview Survey, January 2021–March 2022. National Center for Health Statistics. July 2022.

The percentage of Americans who lack health insurance hit an all-time low of 8% in the first quarter of this year, reflecting an increase of 5.2 million people who gained coverage since 2020, according to a report by the federal Department of Health and Human Services (HHS) released on Tuesday. 

Using data from the National Health Interview Survey and the American Community Survey, the report from the HHS Assistant Secretary for Planning and Education (ASPE) shows the effect of better subsidies for health insurance that consumers buy on the Affordable Care Act’s marketplaces, increased federal efforts to encourage the uninsured to enroll, the continuous enrollment provisions in the federal-and-state Medicaid program and recent decisions in several states to increase enrollment in Medicaid, HHS said in a press release

Since 2019, seven states have expanded enrollment in the federal-and-state funded Medicaid program, according to Louise Norris at HealthInsurance.org. Those states are: Virginia and Maine in 2019; Utah, Idaho, and Nebraska in 2020; and Oklahoma and Missouri last year, she wrote.

The HHS announcement is significant for three reasons. First, the all-time low 8% rate means that about 26.4 million people lack health insurance, down from 48 million in 2010, according to an ASPE report last year. Second, the report includes a table showing changes in the uninsured rates in each state for low-income adults ages 18 to 64 from 2018 to 2020. In 18 states (15 of which expanded Medicaid), the uninsured rates for this population dropped in those years.

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New website helps states share home and community-based services, plus how to report on this topic

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The Centers for Medicare & Medicaid Services (CMS) has launched a new “one-stop-shop” for state Medicaid agencies and stakeholders to improve transparency and encourage innovation for home and community-based services (HCBS).

HCBS allow people enrolled in Medicaid to receive services and support in a preferred setting outside of an institution, such as in their home. While Medicaid law requires states to cover nursing facilities and other institutional care, it does not require them to cover the full range of HCBS. States must apply for HCBS waivers to provide these services in the home environment.

This new webpage grants state Medicaid agencies and stakeholders access to other states’ plans or proposals to enhance, expand, and strengthen these services across the country using new Medicaid funding under the American Rescue Plan Act of 2021 (ARP). (The landing page is very text-heavy; you can find individual state plans by scrolling down towards the bottom of that page).

Journalists can tap into this resource to hold states and agencies accountable
for delivering promised services.

Some key information available on this website includes: 

  • Each state’s initial spending plan and narrative; CMS approval status and response.
  • A Home and Community Based Settings Toolkit to assist states develop Home and Community-Based 1915(c) waivers or renewal application(s).
  • Detailed guidelines from on how American Rescue Plans funds can be used.
  • Information about aging and aging services in rural America.

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Federal law criticized for excluding certain Medicaid patients from psychiatric care

man with face in hands

Photo by Daniel Reche

A federal law that has long led to severely mentally ill Medicaid patients not receiving needed care at many psychiatric facilities has outlived its presumed usefulness, according to a recent report.

A February 2021 analysis by the Manhattan Institute documents how a federal institutes for mental diseases (IMDs) exclusion enacted in 1965 discourages states from investing in patient care and restricts care and access. The IMD exclusion bars states from using the federal portion of Medicaid payments for services rendered “inside or outside” IMDs. They include hospitals, nursing homes or other facilities with 16 or more beds that primarily provide mental health care. The exclusion targets Medicaid patients ages 21 to 64 years old. Continue reading

Does care suffer as private equity firms buy struggling nursing homes?

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Photo: Gilbert Mercier via Flickr

Private equity firms are in the business of making money. On the surface, there is nothing wrong with that. However, a disturbing story in The Washington Post alleges that when private equity is involved in the buying and selling of nursing homes, things are often worse than they seem.

The story, by reporters Rebecca Tan and Rachel Chason, looks at Portopiccolo Group, which has a history of buying one- and two-star rated facilities. Continue reading