Transformative times ahead for Medicaid

Transformative times ahead for Medicaid

Historic year for Medicaid

Medicaid currently provides health and long-term care for 66 million low-income Americans. Additionally, Medicaid provides assistance to 9.5 million low-income Medicare beneficiaries.

The thirteenth annual Kaiser Family Foundation Medicaid report, predicts that fiscal years 2013 and 2014 will be historic and transformative for Medicaid. The study reports on the results of surveys of Medicaid directors and budget staff for all 50 states and the District of Columbia (DC). Enrollment and budget data from all states and DC were analyzed from fiscal years 2011 and 2012. Below are some highlights from the report;

  • Factors shaping Medicaid; implementation of Affordable Care Action (ACA), delivery and payment system reform, economic conditions, cost containment and administrative improvement programs
  • Coverage expansion for low-income Americans with incomes up to 138% of federal poverty level ($15,856/year for individuals in 2013), along with other enrollment exemptions
  • Twenty-five states (including DC) have announced plans to move forward with Medicaid expansion
  • Medicaid enrollment and spending expected to increase in 2014 due to increases in coverage and federal funds regardless of expansion status
  • Due to improved economy, most states are increasing provider reimbursements, improving benefits, and restoring or adopting new programs
  • ACA requires Medicaid to increase primary physician rates to 100% of Medicare as of 1/2013. Many states have or will also increase specialist rates