Kaiser Family Foundation

What are the key provisions in the 2010 comprehensive health reform? Read a summary of the new law, including the CLASS Act, and changes make to the law by subsequent legislation. The document focuses on changes in coverage, control of health care costs, and improvement of the health care delivery system. Also included is a timeline providing implementation dates.

States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. This report describes 10 operating individual budget model programs that serve older persons and identifies four areas of program design that are of particular importance to the success of the individual budget model.

This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver.

Developing HCBS alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of long-term care dollars still go toward institutional care, the national percentage of spending on HCBS has more than doubled from 19 percent in 1995 to 41 percent in 2007. This article presents a summary of the main trends to emerge from the latest (2006) expenditures and participant data for the three main Medicaid HCBS programs.

Leading health reform proposals in both the House and Senate include a Medicaid expansion to help eliminate state variation in the current program and to broaden health coverage. Because Medicaid is jointly administered and financed by states and the federal government, changes will have direct impact on states. While health reform legislation could have many implications, this brief highlights some of the potential benefits and costs associated with Medicaid expansion in the reform proposals.

This fact sheet discusses the status of Medicaid and state budgets in light of the continuing recession and the federal fiscal relief provided to state Medicaid programs through the American Recovery and Reinvestment Act (ARRA). The ARRA money has helped address budget shortfalls, preserve Medicaid eligibility and soften program cuts. But ARRA funds are set to expire on Dec. 31, 2010, which may prompt some states to turn to cost-saving measures such as restrictions on Medicaid eligibility.

This brief summarizes lessons in offering more home and community-based services from states at the forefront of the effort. It describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states.

This brief highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS). Among the key ideas drawn from a working group discussion at the Foundation are the benefits of providing additional federal financing to states to provide Medicaid HCBS and to administer these benefits.

Annual survey of all 50 States finds that during this time of recession the number of people on Medicaid is greatly increasing, as is the amount of money being spent on the program by individual States. Despite federal assistance from the American Recovery and Reinvestment Act (ARRA), this leads to further strain on already tight State budgets. This trend is expected to continue & States should be expecting a predicted increase of 6.3% on Medicaid spending in the 2010 fiscal year.

This issue brief examines the early successes and challenges of MFP. A 2008 survey of 29 states receiving MFP grants turned up several key findings, including that several hundred people have moved from institutional to community settings; that states are providing a broad range of services to facilitate transition; that housing issues for MFP participants are a major challenge for states; and that the severe economic downturn had not yet prompted states to scale back their efforts.