Medicaid agencies administer one of the most complex public health programs in the nation. Each day, they determine eligibility, process high volumes of pharmacy and medical claims, coordinate benefits with other payers, and oversee provider participation—all while ensuring uninterrupted access to care for millions of...
As states begin planning for fiscal year (FY) 2027, Medicaid programs are entering a period of increasing financial constraint. Slower revenue growth, persistent healthcare cost inflation, and federal policy changes enacted through the 2025 budget reconciliation law are reshaping budget expectations. While enrollment growth has...
State governments are facing a fiscal reality they can no longer ignore: Medicaid is rapidly becoming one of their largest—and least controllable—budget items. With enrollment at record highs following years of Medicaid expansion and pandemic-era protections, the cost of maintaining the program is now consuming...
With federal budget cuts putting Medicaid funding at risk, states are working to ensure that healthcare services remain available for millions of Americans. Rising costs, expanding enrollment, and financial pressures are driving policymakers to find solutions that balance budget constraints with the need for accessible...
Introduction Recent budget proposals in Congress have put Medicaid at risk for significant funding cuts. If these reductions move forward, states will face major challenges, such as fewer benefits, stricter eligibility rules, and financial strain on healthcare providers. Since Medicaid supports millions of low-income individuals, families,...
Over the past three decades, Medi-Cal, California's Medicaid program, has undergone considerable changes and expansion. By 2016, the program provided coverage to more than one in three Californians, and as of January 2024, eligibility has been extended to include all residents with incomes below specific...
Since its passage in 1965, the Medicaid program has grown to become the single largest payer for health care in the United States, costing $671.2 billion in 2020. Because of surges in enrollment from the pandemic and the present administration's priorities, spending is only projected...
In January 2020, the Department of Health and Human Services declared COVID-19 a public health emergency. Since then, the PHE has been renewed nine times, but it is scheduled to expire in August unless it is extended again. Its end will have a major effect...