DATAWATCH: Trends In State Medicaid Eligibility, Enrollment Rules, And Benefits

• Published in: Health affairs (Millwood, Va.) Vol. 39; no. 11; pp. 1909 - 25
• Main Authors: Fox, Ashley M, Feng, Wenhui, Zeitlin, Jennifer, Howell, Elizabeth A
• Format: Journal Article
• Language: English
• Published: Chevy Chase The People to People Health Foundation, Inc., Project HOPE 01.11.2020
• Subjects: Annual reports; Childrens health; Childrens health insurance programs; Criteria; Eligibility; Enrollments; Expansion; Families & family life; Government programs; Health care industry; Health care policy; Health insurance; Immigrants; Low income groups; Medicaid; Noncitizens; Patient Protection & Affordable Care Act 2010-US; Poverty; Pregnancy; Trends; Waivers; Washington DC; United States > US
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2019.01350

Recent literature has focused on the impact of the differential adoption by states of the Affordable Care Act's Medicaid expansion. However, additional Medicaid policy dimensions exist where state-level trends in coverage have varied, including eligibility, benefits, and administrative burden, both before and after implementation of the Affordable Care Act.It is estimated that from 2014 to 2016 as many as 14.5 million people became insured through Medicaid and the Children's Health Insurance Program (CHIP) as a consequence of the Medicaid expansion that was adopted as part of the Affordable Care Act (ACA) in 2010.1 Medicaid covered 20 percent of the US population in 2018.2 Many more people would have been insured if all states had undertaken the Medicaid expansion. However, although states' decisions about whether to expand Medicaid have received extensive attention,3 fewer studies have measured and reported on other ways that Medicaid varies across states (including in their eligibility policy criteria for other categorical groups, reduction of barriers to enrollment, and benefit comprehensiveness), many of which predate the ACA. This study provides a broader picture of state Medicaid programs beyond Medicaid expansion by comprehensively measuring state Medicaid policy across four dimensions over the period from 2000 to 2016-18 (exhibit 1).