Medicaid Integration

The latest resource from Justice in Aging focuses on Medicare and LGBTQ+ older adults, addressing the challenges they face in accessing and utilizing their Medicare benefits. The publication includes two fact sheets to provide essential information and tips for LGBTQ+ older adults with Medicare and their advocates. The first fact sheet, "Marriage, Medicare, and Medicaid: What Same-Sex Couples Need to Know," covers Medicare coverage rules for spouses and the impact of spousal income on programs affecting Medicare costs. The second fact sheet, "Medicare & Transgender Older Adults: What Transgender People Need to Know," addresses critical issues related to gender identification, surgeries, transition-related drugs, and sex-specific procedures.

Arnold Ventures has introduced a new project titled "Melissa & Ann: Navigating America's Tangled Health Care Safety Net," a compelling photo essay featuring the lives of two women living in Southern California who are dually enrolled in Medicare and Medicaid. Through the lens of award-winning photographer Isadora Kosofsky, this project sheds light on the daily triumphs, challenges, and complexities faced by older adults and people with disabilities navigating the health care system. By sharing these intimate stories, Arnold Ventures aims to inspire policymakers to prioritize improving care for the diverse population of low-income older adults and people with disabilities who are dual-eligible for Medicare and Medicaid.

The Centers for Medicare & Medicaid Services (CMS) has determined that power seat elevation equipment on Medicare-covered power wheelchairs falls within the benefit category for durable medical equipment (DME) based on the Social Security Act and relevant regulations. After considering public comments, CMS has expanded coverage beyond the proposed decision, finding that power seat elevation equipment is reasonable and necessary for individuals using complex rehabilitative power-driven wheelchairs, subject to specific conditions.

The Centers for Medicare & Medicaid Services (CMS) released an informational bulletin that describes the end dates of certain COVID-19-related Medicaid and the Children’s Health Insurance Program (CHIP) coverage and enhanced federal funding resulting from the May 11th PHE end date. The bulletin includes information on COVID-19 vaccines, vaccine administration, testing, and treatment; telehealth flexibilities; and implications of the end of the COVID-19 National Emergency for section 1135 waivers. Additional federal guidance on flexibilities enabled by the COVID-19 emergency declaration and how they will be impacted by the end of the COVID-19 PHE can be found here.

On May 11th, The Centers for Medicare & Medicaid Services (CMS) released updated 2023 SSI and spousal impoverishment standards. Certain Medicaid income and resource standards are adjusted annually in accordance with changes in the SSI federal benefit rate and the Consumer Price Index, reflecting an effective date of January 1, 2023. Additionally, per section 1924 of the Social Security Act, the community spouse’s minimum monthly maintenance needs allowance (MMMNA) is adjusted based on changes to the federal poverty level and reflects a July 1, 2023 effective date. Additionally, the community spouse’s monthly housing allowance, calculated based on a percentage of the MMMNA, is adjusted each July 1st.

KFF unveiled their “Medicaid Enrollment and Unwinding Tracker” featuring state-level Medicaid/CHIP enrollment data for the 50 states and the District of Columbia as well as any unwinding or monthly renewals, disenrollments, and other measures that may be available for states. The tracker also provides information on state-specific Medicaid renewal policies, eligibility policies, and system capacity measures. The tool includes national data on Medicaid enrollment as reported by the Centers for Medicaid and Medicare Services (CMS); however, these data lag by several months and do not provide a current picture of net changes in Medicaid enrollment.

CMS created consumer fact sheets that provide information on Medicare, Medicaid, and private insurance coverage of COVID-19 tests following the end of the PHE on May 11, 2023. The fact sheets are available in both English and Spanish. Centers for Medicare & Medicaid Services (CMS)

On the 60th anniversary of Older Americans Month, the White House has issued a proclamation recognizing the invaluable contributions of our Nation's seniors. The proclamation celebrates the progress made through programs such as Medicare and Social Security in raising many seniors out of poverty and providing affordable healthcare. However, it also acknowledges the need for continued efforts to ensure seniors can age with dignity and financial security. Specifically, President Biden calls on Congress to improve accessibility to high-quality care and support for caregivers, increase funding for nutrition services, and improve the quality and safety of nursing homes to help ensure that all older adults are supported.

KFF’s analysis released March 2, 2023, “Medicaid Enrollment Growth: Estimates by State and Eligibility Group Show Who may be at Risk as Continuous Enrollment Ends”, presents findings from the organization’s evaluation of Medicaid and Children’s Health Insurance Program (CHIP) enrollment data. KFF estimates nearly 95 million people enrolled in Medicaid and CHIP in March 2023 – an increase of 23.3 million enrollees with over half of the enrollee increase among adults under age 65 and nearly one-third among children. Also, five states – California, New York, Texas, Florida, and Illinois – comprise over one-third of the increase in Medicaid and CHIP enrollment while the rate of growth in enrollment varies among states.

MACPAC has released its June 2022 Report to Congress on Medicaid and CHIP. The report recommends measures that Congress can take to better monitor access to care for Medicaid beneficiaries, improve the oversight and transparency of managed care directed payments, increase access to vaccines for adults enrolled in Medicaid, encourage the uptake of health information technology in behavioral health, and better integrate care for Medicaid and Medicare dual-eligibles. The commission also offers policy levers that states and the federal government can use to promote equity in Medicaid.