# Medicaid * **Definition:** A joint federal and state program that provides health coverage to eligible individuals and families with low incomes, helping with healthcare costs for those with limited income and resources. * **Taxonomy:** Healthcare Topics / Medicaid ## News * Selected news on the topic of **Medicaid**, for healthcare technology leaders * 31.7K news items are in the system for this topic * Posts have been filtered for tech and healthcare-related keywords | Date | Title | Source | | --- | --- | --- | | 5/8/2025 | [**Seeking Spending Cuts, GOP Lawmakers Target a Tax Hospitals Love To Pay**](https://californiahealthline.org/news/article/medicaid-provider-tax-hospitals-gop-spending-cuts-budget/) | [[California Healthline]] | | 5/2/2025 | [**Government Watchdog Expects Medicaid Work Requirement Analysis by Fall**](https://kffhealthnews.org/news/article/gao-federal-watchdog-medicaid-work-requirement-analysis-georgia/) | [[KFF Health News]] | | 4/25/2025 | [**Medicaid cuts would impact more than a quarter of Ohioans, children and the elderly most of all**](https://www.aol.com/medicaid-cuts-impact-more-quarter-090035118.html) | [[AOL]] | | 4/24/2025 | [**Waymark Announces Partnership With Sentara Health Plans to Improve Medicaid Care ...**](https://www.morningstar.com/news/accesswire/1018274msn/waymark-announces-partnership-with-sentara-health-plans-to-improve-medicaid-care-delivery-in-virginia) | [[Morningstar]] | | 4/16/2025 | [**History Repeats? Faced With Medicaid Cuts, States Reduced Support For Older Adults And Disabled People**](https://www.healthaffairs.org/content/forefront/history-repeats-faced-medicaid-cuts-states-reduced-support-older-adults-and-disabled) | [[Health Affairs]] | | 4/13/2025 | [**Federal Medicaid cuts threaten child health in Montana - Yahoo**](https://www.yahoo.com/news/federal-medicaid-cuts-threaten-child-100252933.html) | [[Yahoo]] | | 4/11/2025 | [**CMS Cuts Medicaid Funding For Some Non-Medical In-Home Services**](https://homehealthcarenews.com/2025/04/cms-cuts-medicaid-funding-for-some-non-medical-in-home-services/) | [[Home Health Care News]] | | 4/10/2025 | [**Small-town America in crosshairs of Medicaid cuts**](https://www.beckershospitalreview.com/finance/small-t-america-in-crosshairs-of-medicaid-cuts/) | [[Beckers Hospital Review]] | | 4/10/2025 | [**Medicaid 'decision time' has arrived**](https://www.beckershospitalreview.com/finance/medicaid-decision-time-has-arrived/) | [[Beckers Hospital Review]] | | 4/7/2025 | [**Republicans in Congress are eyeing cuts to Medicaid. But what does Medicaid actually do?**](https://www.yahoo.com/news/republicans-congress-eyeing-cuts-medicaid-181800022.html) | [[Yahoo]] | | 4/4/2025 | [**HHS layoffs could complicate coverage for dual-eligible patients**](https://www.modernhealthcare.com/policy/hhs-layoffs-dual-medicare-medicaid-dsnps) | [[Modern Healthcare]] | | 3/27/2025 | [**Medicaid, SNAP cuts to lead to 1M job losses: Commonwealth Fund - Fierce Healthcare**](https://www.fiercehealthcare.com/regulatory/medicaid-snap-cuts-lead-1m-job-losses-commonwealth-fund) | [[FierceHealthcare]] | | 3/19/2025 | [**Tribal Health Leaders Say Medicaid Cuts Would Decimate Health Programs**](https://californiahealthline.org/news/article/tribal-indian-health-service-ihs-medicaid-cuts-underfunding-fallout/) | [[California Healthline]] | | 3/6/2025 | [**Thousands Sign Christian Petition Rebuking GOP's Potential Medicaid Cuts - Newsweek**](https://www.newsweek.com/thousands-sign-christian-petition-rebuking-gops-potential-medicaid-cuts-2040668) | [[Newsweek]] | | 2/27/2025 | [**Column: The family-values hypocrisy of cutting Medicaid - Los Angeles Times**](https://www.latimes.com/politics/newsletter/2025-02-27/chabria-column-medicaid-family-values-cut-politics) | [[LA Times]] | | 2/27/2025 | [**Medicaid extension policies covering all immigrants found to reduce inequities in postpartum insurance coverage**](https://medicalxpress.com/news/2025-02-medicaid-extension-policies-immigrants-inequities.html) | [[MedicalXpress]] | | 2/27/2025 | [**Percentage of population under Medicaid in each state**](https://www.beckersdental.com/benchmarking/45638-percentage-of-population-under-medicaid-in-each-state.html) | [[Beckers Dental]] | | 2/26/2025 | [**Did Medicaid Get Cut? What House Budget Resolution Means for Health Care**](https://www.newsweek.com/medicaid-republica-budget-donald-trump-healthcare-2036371) | [[Newsweek]] | | 2/25/2025 | [**Medicaid work requirements explained amid GOP budget talks**](https://www.modernhealthcare.com/policy/medicaid-work-requirements-gop-budget) | [[Modern Healthcare]] | | 2/25/2025 | [**House sets up potential Medicaid cuts with budget bill passage**](https://www.modernhealthcare.com/politics-policy/house-budget-passes-medicaid) | [[Modern Healthcare]] | | 2/25/2025 | [**House Passes Budget Resolution Cutting Billions From Medicaid Funding**](https://www.ajmc.com/view/house-passes-budget-resolution-cutting-billions-from-medicaid-funding) | [[AJMC]] | | 2/21/2025 | [**Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury**](https://www.ajmc.com/view/insurance-payer-is-associated-with-length-of-stay-after-traumatic-brain-injury) | [[AJMC]] | | 2/11/2025 | [**Medicaid covers nearly 1 in 4 Virginians. Here's what could happen if federal funding goes away.**](https://www.yahoo.com/news/medicaid-covers-nearly-1-4-214000419.html) | [[Yahoo]] | | 2/8/2025 | [**Southern states are funding rural health, yet rejecting Medicaid**](https://www.modernhealthcare.com/policy/medicaid-expansion-southern-states-rural-health) | [[Modern Healthcare]] | | 11/11/2024 | [**With Trump's return to the White House, some fear Medicaid cuts**](https://www.chiefhealthcareexecutive.com/view/with-trump-s-return-to-the-white-house-some-fear-medicaid-cuts) | [[Chief Healthcare Executive]] | ## Topic Overview (Some LLM-derived content — please confirm with above primary sources) ### Key Players - **CMS (Centers for Medicare & Medicaid Services)**: The federal agency overseeing Medicaid and CHIP, focusing on enrollment processes and healthcare access. - **Centers for Medicare & Medicaid Services (CMS)**: The federal agency that administers the nation's major healthcare programs, including Medicaid, overseeing regulations and funding. - **State Governments**: Entities responsible for administering Medicaid programs at the state level, including determining eligibility and coverage options. - **House Republicans**: A political group proposing significant spending cuts to Medicaid, which could impact millions of low- and middle-income Americans. - **Democrats**: Members of the U.S. Congress opposing proposed cuts to Medicaid, emphasizing the program's importance for vulnerable populations. - **U.S. Congress**: The legislative body considering significant cuts to Medicaid funding, which could impact millions of Americans. - **Healthcare Providers**: Hospitals and health centers that rely on Medicaid funding for a significant portion of their operations and patient care. - **Molina Healthcare**: A managed care organization that provides Medicaid services and is facing operational challenges due to eligibility reassessments. - **Senator Maggie Hassan**: Advocated for the critical role of Medicaid in providing healthcare to disabled individuals and those in recovery. - **House Budget Committee**: A congressional committee responsible for drafting the budget resolution, which has proposed significant cuts to Medicaid funding. ### Partnerships and Collaborations - **North Carolina Medicaid Initiative**: A program allowing Medicaid funds to be used for social services, improving health outcomes for vulnerable populations. - **Partnership for Medicaid**: A coalition of hospital trade groups advocating for the preservation of Medicaid. - **CMS and State Medicaid Programs**: CMS collaborates with state Medicaid programs to implement new regulations aimed at improving access and quality of care. - **New Mexico Medicaid Trust Fund**: A bipartisan initiative to create a $2 billion fund to safeguard the state's Medicaid program amid potential federal cuts. - **Waymark and Aetna Medicaid**: Collaboration aimed at improving access to preventive care for Medicaid members, showcasing the effectiveness of coordinated healthcare. - **Unite Us and Missouri HealthNet**: This collaboration aims to address social determinants of health by connecting Medicaid recipients with managed care organizations and community-based organizations. - **Center for Maternal and Child Health Medicaid Partnerships (CMMP)**: A five-year initiative funded by HRSA aimed at enhancing collaboration between Medicaid, CHIP, and Title V programs to improve maternal and child health outcomes. - **Families USA Coalition**: A coalition of 344 organizations urging Congress to protect and strengthen Medicaid, emphasizing its role in providing health and economic security. - **State Governments**: Various states are involved in Medicaid management and are responding to proposed federal changes. - **Twentyeight Health Partnerships**: New Medicaid partnerships with Aetna, AmeriHealth, and Molina to provide telemedicine and women's health services. - **Twentyeight Health and Medicaid Insurers**: Twentyeight Health has established partnerships with Medicaid insurers like Aetna and Molina Healthcare to expand access to reproductive health services. - **Healthcare Providers**: Providers are concerned about the impact of Medicaid cuts on their ability to serve low-income patients. - **Kaiser Permanente and Maryland**: Renewed partnership to continue providing Medicaid services, ensuring public health stability. - **Bipartisan Legislative Efforts**: Various stakeholders, including hospitals and consumer advocates, are mobilizing to oppose proposed Medicaid cuts, reflecting a collaborative effort to protect the program. - **Advocacy Groups**: Organizations like the National Down Syndrome Congress and various healthcare advocates are collaborating to oppose Medicaid cuts and highlight their impact on vulnerable populations. - **CMS and States**: Collaboration to enhance Medicaid Beneficiary Advisory Councils (BAC) to incorporate lived experiences into Medicaid decision-making. - **Econometrica, Inc.**: Appointed as the prime contractor for a Technical Assistance Center to enhance Medicaid School-Based Services. - **Michelle Martin's Leadership at PMHC**: Aimed at enhancing quality in Medicaid home and community-based services through collaboration with policymakers. - **Waymark and Sentara Health Plans**: A partnership aimed at improving community-based care for Medicaid members in Virginia, focusing on reducing emergency visits and hospitalizations. - **AxisCare**: Launched AxisCare Medicaid Billing to streamline billing processes for home care agencies, enhancing operational efficiency. ### Innovations, Trends, and Initiatives - **Pilot Programs**: Medicaid has initiated diverse pilot programs that extend beyond traditional healthcare, serving low-income individuals and those with disabilities. - **Whole-Person Care Focus**: Medicaid is transitioning from basic healthcare to a model emphasizing whole-person care, which includes addressing social determinants of health. - **Medicaid Work Requirements**: Proposed by Republican lawmakers to encourage employment among Medicaid recipients, with mixed support and concerns about coverage loss. - **Integration of Medicare and Medicaid**: Current discussions focus on improving policies for dually eligible individuals, emphasizing the need for comprehensive care. - **Medicaid Expansion**: States like North Carolina and South Dakota have expanded Medicaid eligibility, reflecting a trend towards increasing health coverage for low-income populations. - **Section 1115 Waivers**: States have been granted flexibility to address public health challenges, allowing for innovative approaches to Medicaid. - **Social Determinants of Health**: New York's pilot program using Medicaid funds to address housing, nutrition, and transportation services to improve health outcomes. - **Proposed Medicaid Rule by CMS**: Aims to close loopholes that allow states to reduce their financial contributions while increasing federal payments. - **Medicaid ACOs in Massachusetts**: Demonstrated improved prenatal and postpartum care engagement, highlighting the positive impact of Medicaid ACO models. - **Improper Payments Audits**: Calls for more frequent eligibility checks and audits to reduce improper Medicaid payments, estimated at $543 billion from 2015 to 2024. - **Medicaid ACO Models**: Advocacy for implementing Medicaid accountable care organization models in states lacking them to improve maternal health outcomes. - **State Directed Payments**: A funding mechanism that allows states to enhance healthcare access for vulnerable patients, though concerns about transparency and misuse exist. - **CMS New Policies**: Finalized rules to enhance access to Medicaid and CHIP managed care, including maximum appointment wait time standards. - **ALLHealth Proposal**: A plan in Alabama to extend insurance coverage to uninsured individuals using Medicaid expansion funds to subsidize private insurance premiums. - **Auto-Renewals**: Under the Biden administration, the rate of auto-renewals for Medicaid increased significantly, simplifying the enrollment process. - **Medicaid Expansion under the Affordable Care Act**: States that expanded Medicaid saw slower increases in death rates during the COVID-19 pandemic, highlighting the program's protective health effects. - **Machine Learning in Medicaid**: Utilization of machine learning techniques to identify subpopulations that benefit most from Medicaid coverage, particularly in managing cardiovascular risk factors. - **Medicaid VBPs for Patients Act**: Legislation aimed at clarifying value-based pricing in Medicaid to enhance access to expensive therapies. - **Well-inois Initiative**: A proposed solution in Illinois to allow individuals to pay premiums for Medicaid, aiming to attract healthier participants and improve reimbursement rates. ### Challenges and Concerns - **Public Misunderstanding of Medicaid**: Many beneficiaries do not recognize their coverage as Medicaid, leading to confusion and potential loss of access to necessary healthcare services. - **Systemic Issues in Medicaid Management**: Delays and frustrations in obtaining Medicaid benefits due to glitches and inefficiencies in state systems, as seen in Georgia. - **Medicaid Unwinding**: The end of continuous coverage requirements has led to millions losing Medicaid coverage, raising concerns about access to healthcare. - **Medicaid Funding Cuts**: Proposed cuts to Medicaid funding by Congress could destabilize health systems reliant on Medicaid reimbursements, particularly in financially strained states. - **Misunderstanding of Medicaid**: A lack of clear understanding among the public regarding Medicaid's functions and importance, particularly in states like Utah. - **Potential Cuts to Medicaid**: Proposed cuts of up to $880 billion could severely impact coverage for millions, particularly vulnerable populations such as children, seniors, and individuals with disabilities. - **Access to Care**: Low reimbursement rates in states like Illinois deter healthcare providers from accepting Medicaid, limiting access for beneficiaries. - **Provider Participation**: Low reimbursement rates and administrative burdens are leading to provider reluctance to participate in Medicaid, exacerbating access issues. - **Improper Payments**: Improper payments in Medicaid have increased significantly, highlighting the financial strain caused by ineligible enrollees remaining in the program. - **Economic Impact**: Potential Medicaid cuts could adversely affect community health and economic stability, particularly in states with high Medicaid enrollment. - **Fraud and Abuse in Medicaid**: Significant deficiencies in the Medicaid program's ability to detect fraud, waste, and abuse, with improper payments reaching $98.6 billion in FY 2022. - **Medicaid Portal Outages**: Recent outages in Medicaid payment portals raised concerns about cash flow issues for states and healthcare providers. - **Coverage Gaps for Pregnant Women**: Mississippi faces delays in implementing a new Medicaid presumptive eligibility program for pregnant women. - **Rural Healthcare Impact**: Cuts to Medicaid funding may devastate rural healthcare systems, where many patients rely on Medicaid for coverage. - **Financial Strain on States**: Projected increase in Medicaid spending by 7% in FY 2025 amid declining enrollment, creating financial pressures on state budgets. - **Medicaid Unwinding Process**: Over 25 million individuals disenrolled during the unwinding process post-COVID-19, raising concerns about access to care and the uninsured rate. ## Related Topics [[Medicare]]; [[Medicaid Cuts]]