The poverty guidelines for 2015 are available and published here in the Federal Register. These guidelines -- often cited as 100 percent of the federal poverty line -- are used to determine eligibility for a number of stata and federal programs. Sometimes eligibility is greater than 100 percent; for instance, the Affordable Care Act allows states to expand Medicaid eligibility to 138 percent of federal poverty. 

Gov. Mike Pence announced today federal approval of his state’s Medicaid waiver to expand eligibility to all persons with incomes below 138 percent of the federal poverty level, according to the Indy Star newspaper.

Pence has lobbied hard for what he calls HIP 2.0, expanding a smaller consumer-driven health plan called Healthy Indiana Plan, rather than expand the traditional Medicaid program.

“The expanded and updated HIP 2.0 is based on a program that has been serving 60,000 low-income Hoosiers in our state for seven years,” said Governor Pence in a press release. “It is a proven model for Medicaid reform across the nation.”

Up to 350,000 people will be eligible according to the press release. The state will start taking applications today, Jan. 27, for coverage to begin on Feb. 1, 2015.

Top Five 2015 Health Issues: A Further Examination

A flurry of state governors - in the 24 states that have not yet expanded Medicaid - are talking about expanding Medicaid eligibility as allowed under the Affordable Care Act. Many of these governors are offering up solutions that they say are designed uniquely for their state, carefully differentiating the new proposals from “traditional” Medicaid. This activity is likely to continue throughout 2015. Outside ACA issues, states will consider a number of health delivery issues. These include how to match the workforce to the need for professionals and how to expand some service areas such as mental health and substance abuse.

CSG Director of Health Policy Debra Miller outlines the top five issues in health policy for 2015, including Medicaid expansion, growing the health workforce, integrating health and human services, long-term care, and mental health and substance abuse. 

Calling his proposal Insure Tennessee, Gov. Bill Haslam said yestereday he is requesting an amendment to the state’s TennCare demonstration project for a two year pilot project to cover as many as 200,000 low-income individuals under the Medicaid expansion available through the Affordable Care Act, according to numerous press reports.

State Medicaid programs are large and complex and their directors are faced with implementing changes required by the Affordable Care Act at the same time they continue to work with limited resources, both fiscal and human. Medicaid programs are also leading by example in major transformations of the health care system, including payment reforms, quality oversight, system accountability, and targeted care coordination.

Since 1997, states have been able to bill for Medicaid-enrolled inmates who leave prisons or jails longer than 24 hours for health treatment in a hospital or nursing facility. That provision is an important but little-known exception to the federal prohibition on spending Medicaid funds for health services to inmates of state prisons and local jails, according to Dr. Nicole Jarrett, who spoke at September’s CSG Medicaid Leadership Policy Academy.

Pennsylvania and New Hampshire are the latest states to expand Medicaid eligibility, securing federal approval of their states' waiver proposals. Those two states join Arkansas, Iowa and Michigan that also have implemented Medicaid expansion outside of the traditional Medicaid program model. Indiana has a pending waiver application. 

It is likely that some of the 22 states that so far have not expanded Medicaid may still do so. To keep up with...

WASHINGTON, D.C.—State Medicaid programs increasingly are depending on managed care arrangements, Julia Paradise, associate director of the Kaiser Commission on Medicaid and the Uninsured, told state legislators attending the CSG Medicaid Leadership Policy Academy in Washington, D.C., Sept. 15-17. “States see managed care as a strategy to extract savings,” she said.

Twenty-one state legislators from 14 states gathered in Washington, D.C. on Sept. 15-17, 2014, for a CSG-led Medicaid Leadership Policy Academy. Almost 50 percent of the attendees were chairs or vice-chairs of health committees in their home states. Nearly half were health care professionals outside their legislative duties. 

The meeting was a follow-up to the Medicaid Policy Academies CSG has held in 2012, 2013, and 2014 for legislatos who have been newly elected...

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