Medicaid in an Uncertain Era: Assessing the Policy Implications of Moving Forward


Since 2014, when the Affordable Care Act's major provisions went into effect, Commonwealth Fund-supported work by Sara Rosenbaum and her colleagues has informed policymakers about Medicaid's transformed role in public insurance. Their issue briefs and blog posts have explored how states have implemented the eligibility expansion and what impact the expansion has had on low-income Americans. The project team has also analyzed the American Health Care Act in its various forms, including how the bill, if it is enacted, might affect the Medicaid program, consumers, state budgets, and state flexibility. Going forward, Rosenbaum and her colleagues will play an important role in tracking legislative and administrative developments, their implications for Medicaid and its beneficiaries, and states' experiences using Medicaid to cover their low-income residents. The team's first set of activities will involve rapid analysis of federal legislative and administrative developments pertaining to Medicaid and the Children's Health Insurance Program. The researchers will focus on so-called 1115 and 1332 federal waivers, which permit states flexibility in implementing Medicaid. The second set of activities will entail examining five to seven states that were early adopters of the "traditional" Medicaid expansion. Through analyses and interviews with experts, the team will explore the practical and policy implications of expansion, including: challenges arising from changes to the eligibility determination, enrollment, and renewal processes; issues around redesigning and growing managed care plan purchasing systems; and the potential effects of significant congressional action on Medicaid. These analyses will yield important insights for federal and state policy leaders and the media about the continuing transformation of Medicaid and the potential effects of legislative and regulatory changes to beneficiaries and states.

Grant Details

Grantee Organization:
George Washington University
Principal Investigator:
Sara Rosenbaum, J.D.
Award Amount:
Approval Date:
July 11, 2017

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