Overview of Alternative Medicaid Expansion Waivers
Section 1115 waivers allow states to waive certain Medicaid statutory requirements in order to advance state policy priorities and test innovations in their Medicaid programs, provided that they are budget neutral and “further the goals of the Medicaid program.” Since 2014, seven states have used 1115 waivers to implement alternative Medicaid expansions, and these waivers are likely to be leveraged by states in the next four years to advance changes to Medicaid. This issue brief, developed by Manatt Health, provides an overview of the features of these alternative Medicaid expansion waivers.
Shared Measurement and Joint Accountability Across Health Care and Non-Health Care Sectors: State Opportunities to Address Population Health Goals
Health care leaders are well-positioned to use cross-sector approaches to drive improvements in population health in collaboration with state leaders. Through the use of joint measurement and accountability tools, policymakers can help to improve health outcomes to an extent not possible through isolated, medical-centric efforts. This issue brief, developed by Dana Hargunani, MD, MPH, outlines how state agencies can use shared measurement and joint accountability across sectors as tools for improving population health outcomes.
The Buying Value Measure Selection Tool: Strategies for Selecting Measures and Developing Aligned Measure Sets
The “Buying Value Measure Selection Tool” was developed to assist state agencies, private purchasers and other stakeholders in creating aligned measure sets, and was first released in 2014. A recent webinar explained this tool and recent updates for state officials and other stakeholders involved in developing and maintaining aligned quality measure sets for health care entities and programs including for health plans, accountable care organizations, and patient-centered medical homes.
Capping Federal Medicaid Funding: Key Financing Issues for States
Proposals for the incoming Congress and presidential administration to repeal the Affordable Care Act (ACA) have also included a call for a fundamental overhaul of the Medicaid program by imposing caps on federal funding to states. Such capped funding would replace the central feature of Medicaid’s financing structure, the federal government’s legal obligation to share all allowable state Medicaid costs. While the design of various proposals to cap federal Medicaid funding may differ in several ways, they all aim to allow the federal government to achieve budget certainty and reduce federal Medicaid spending.
Repealing Medicaid Expansion: Implications for States
Medicaid expansion under the Affordable Care Act (ACA) has had a positive impact for states, both in terms of the number of people covered and the budget savings and revenue gains that they have realized as a result. A series of recent reports demonstrates the economic impact in states that have expanded Medicaid. A new webinar examined potential repeal of Medicaid expansion under the ACA, and what this would likely mean for states.
Assessment Tool: State Budget Impact of Medicaid Expansion
Medicaid expansion has generated significant savings and new revenues for states, which they have used to finance spending priorities and to offset state Medicaid costs. States that have expanded Medicaid received over $60 billion in federal funds in 2015 and covered approximately 11 million newly eligible people. This tool, developed by Manatt Health, is designed to help states document the impacts of Medicaid expansion on state budgets, including revenue generation and reductions to state general fund spending on Medicaid and other health related programs and services. This tool can be used to demonstrate the impact of expansion as the incoming administration and the new Congress develop proposals to repeal the Affordable Care Act (ACA), potentially including the Medicaid expansion.
Repeal of the ACA Medicaid Expansion: Critical Questions for States
As we approach the beginning of a new presidential administration, there has been continued debate regarding the future of the Affordable Care Act (ACA), much of which has focused on the marketplaces, the mandate, and health insurance reforms such as the ban on insurers’ blocking coverage to those with pre-existing conditions. A potential elimination of the law’s Medicaid expansion to low-income adults and other ACA Medicaid provisions, however, would have far-reaching implications for states and the Medicaid program.
Integrating Health Care and Social Services: Moving from Concept to Practice
Social factors, including economic stability, housing, education, relationships, neighborhood, and other environmental influences, can have a significant impact on individuals’ health status. In order to make improvements to the health of both individuals and their communities, an integrated approach is critical. Policymakers need to bridge the gap between social services and health care delivery in their efforts to make these improvements, and several states have begun to develop innovative approaches toward this integration, which might provide valuable lessons for others.
Using Supplemental Nutrition Assistance Program (SNAP) Information to Facilitate Medicaid Enrollment and Renewal
Recently released CMS guidance and newly established State Plan Amendment authority allows states to use Supplemental Nutrition Assistance Program (SNAP) data, under certain conditions, to enroll and re-determine Medicaid eligibility. In order to assist states in the facilitation of Medicaid enrollment and renewal for eligible SNAP participants, a recent webinar presented some of the necessary considerations for leveraging these data for enrollment purposes.
Examining the Economics of Medicaid Expansion
As evidence of Medicaid expansion’s positive fiscal impact continues to mount across the country, the ability to identify and allocate state general fund dollars “saved” through expansion matters now more than ever. This presentation by Manatt Health reviews the most recent findings on the economic impacts of Medicaid expansion, discusses how state can refine estimates of enrollment, savings, and other expansion impacts, and addresses how states are using information on economic impacts to demonstrate the value of expansion.

