Kaiser Family Foundation

A few recent Medicaid initiatives have emerged that take the program into new directions. States have a number of objectives in developing these approaches, including offering beneficiaries greater choice, promoting personal responsibility and healthier behaviors among enrollees, and looking at the private marketplace. This brief examines how these approaches change financial risk and responsibility for states, the federal government, beneficiaries and providers.

This fact sheet provides information on the new federal requirement that all U.S. citizens and nationals applying for or renewing their Medicaid coverage provide documentation of their citizenship status and examines the implications for Medicaid beneficiaries and the states. This is one of the significant changes the DRA makes to Medicaid effective July 1, 2006.

A new fact sheet and report analysis Medicaid spending and enrollment trends for 2000-2004. Medicaid trends are related to the state of the nation's economy; as the economy has strengthened, increases in enrollment and spending have slowed. Rising enrollment and health care inflation produced most of Medicaid's spending increases. Even with a stronger economy, however, Medicaid's enrollment pressures remain due to demographic trends and continued declines in employer-sponsored insurance.

This report draws on interviews with Medicaid care planners for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

This report draws on interviews with state Medicaid program officials for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act tightened Medicaid eligibility rules. About 43 percent of all nursing home residents eventually become Medicaid eligible. Over the six-year period examined, the authors estimate that, when applying the DRA asset transfer rules, federal savings to Medicaid could amount to $1.87 billion.

Beneficiary-managed individual budget model had its origins in the Cash & Counseling Demonstration. This brief describes the evolution of the model since the original demonstration and provides an overview of state activity. Although Medicaid waivers have been required for individual budget model programs to date, the Deficit Reduction Act gives the option to use this model for an expanded range of home and community based services in the Medicaid plans without having to obtain a waiver.

The statehealthfacts.org had recently added a data on states who offer Individual Budget programs. Use this interactive guide to compare and review activities related to participant-directed care. Data includes the program type, program name, CMS waiver authority, includes elderly, and a status update. Current as of January 2006.

What are the opportunities and potential pitfalls of this new policy that makes major changes to the Medicaid program? This paper offers explanation and analysis of the changes to the long-term services policies including: Asset Transfers, Long-term care Partnership Programs, Family Opportunity Act, Money Follows the Person Demonstration, State Option to Provide HCBS Services, Cash and Counseling Option.

Who are dual eligibles and how do they qualify for Medicaid? This fact sheet describes the over 7.5 million “dual eligibles,” the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and the current policy challenges related to dual eligibles, including the new Medicare prescription drug benefit.