Implications of the President’s 2023 budget for health care
James C. Capretta | Mar 29, 2022 | Federal
The status of Public Health Emergency declarations
James C. Capretta | Mar 16, 2022 | Federal
Medicare Advantage in 2022
James C. Capretta | Mar 1, 2022 | Federal
Background on CMMI’s Direct Contracting Model
James C. Capretta | Feb 18, 2022 | Federal
The CMS-Georgia waiver battle
James C. Capretta | Jan 28, 2022 | Federal
Georgia Gov. Brian Kemp has been engaged in a multi-year back-and-forth with federal officials over the state’s Medicaid and insurance market waiver programs, as reflected in the following timeline of the most notable steps taken by both sides. A final resolution of the standoff is not yet in sight, or
Medicaid’s budget neutrality rules for section 1115 waivers
James C. Capretta | Jan 18, 2022 | Federal
For decades, a focus in Medicaid has been on state proposals that fall outside what is allowable under the program’s normal rules. The Secretary of Health and Human Services (HHS) has wide discretion under section 1115 of the Social Security Act to “waive” legal or regulatory impediments to state initiatives
The status of federal price transparency requirements
James C. Capretta | Dec 28, 2021 | Federal
The health sector has long resisted revealing the prices it charges payers and consumers, but bipartisan pressure from Washington is forcing it to change. New rules are beginning to take effect, or will in the coming years, which will push into the public domain a flood of pricing data. The
The 2020 national health expenditures report
James C. Capretta | Dec 16, 2021 | Federal
The COVID-19 pandemic has been a transformative global event with far-reaching effects that are still unfolding. The recent annual report on national health spending from the Office of the Actuary’s National Health Expenditures Accounts Team in the Centers for Medicare and Medicaid Services (CMS) documents some of the dramatic shifts
Evaluations of four state-run dually eligible demonstrations
James C. Capretta | Dec 1, 2021 | Federal
Federal and state policymakers have been working to improve the cost-effectiveness of care provided to the “dually eligible” -- those entitled to services under both Medicare and Medicaid -- for more than two decades, but the results to date have been disappointing. The two giant public insurance programs are run
A closer look at the House plan to close the coverage gap
James C. Capretta | Nov 12, 2021 | Federal
The current House version of the Build Back Better (BBB) legislation, as posted by the Rules Committee, includes provisions that would close the health insurance coverage gap in states that have declined to expand Medicaid pursuant to the Affordable Care Act (ACA). The individuals who now are ineligible both for