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 Country: United States
 Decade: 2010-2019
 Collection: Congressional Research Service Reports
Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Date: May 25, 2011
Creator: Baumrucker, Evelyne P.
Description: This report summarizes the MOE requirements enacted under American Recovery and Reinvestment Act of 2009 and the Patient Protection and Affordable Care Act as modified by the Health Care and Education Reconciliation Act of 2010 and what these requirements have meant for states in terms of their actions to restrict Medicaid and/or CHIP eligibility. It also summarizes recent legislative activity to repeal the MOE requirements.
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The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

Date: February 25, 2016
Creator: Baumrucker, Evelyne P.; Davis, Patricia A.; Fernandez, Bernadette; Mach, Annie L. & Pettit, Carol A.
Description: This report explores how modified adjusted gross income (MAGI) is defined differently across health programs such as Medicare, the health insurance exchanges under the Affordable Care Act (ACA), and Medicaid. It also discusses why MAGI is used, and how it is applied, specific to each program. The report covers that MAGI is used to determine (1) penalty amounts owed if a person does not comply with the individual mandate or whether an individual is exempt from the individual mandate; (2) eligibility for and the amount of a premium credit to purchase coverage through a health insurance exchange; and (3) Medicaid income eligibility for certain populations.
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Post-Traumatic Stress Disorder and Other Mental Health Problems in the Military: Oversight Issues for Congress

Post-Traumatic Stress Disorder and Other Mental Health Problems in the Military: Oversight Issues for Congress

Date: August 8, 2013
Creator: Blakeley, Katherine & Jansen, Don J.
Description: This report discusses the prevalence of different psychological health concerns within the Armed Forces, current mental health screening and treatments, and DOD responses.
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Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions

Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions

Date: July 15, 2015
Creator: Blom, Kirstin B.
Description: This report responds to a series of frequently asked questions (FAQs) identified to address some of the major updates included in the proposed rule. The FAQs summarize provisions such as the introduction of a minimum medical loss ratio (MLR), guidance on enrolling the long-term services and supports (LTSS) population in managed care, and network adequacy.
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Federal Employees Health Benefits Program: Available Health Insurance Options

Federal Employees Health Benefits Program: Available Health Insurance Options

Date: November 18, 2010
Creator: Chaikind, Hinda & Newsom, Mark
Description: Report that discusses the Federal Employees Health Benefits Program (FEHBP), which provides health insurance coverage to about 8 million government workers.
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Ebola: Selected Legal Issues

Ebola: Selected Legal Issues

Date: December 16, 2014
Creator: Cole, Jared P.; Perry, Rodney M.; Dolan, Alissa M.; Shimabukuro, Jon O.; Garcia, Michael J.; Smith, Jane M. et al.
Description: Several West African countries are currently grappling with an unprecedented outbreak of Ebola virus disease (EVD). Here in the United States, where Ebola is not endemic, a handful of EVD cases have been diagnosed, and domestic transmission of the virus has occurred in only two cases to date. This report provides a brief overview of selected legal issues regarding measures to prevent transmission of Ebola virus and the civil rights of individuals affected by the disease.
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Medicaid Coverage of Long-Term Services and Supports

Medicaid Coverage of Long-Term Services and Supports

Date: December 5, 2013
Creator: Colello, Kirsten J.
Description: This report provides a description of the various statutory authorities that either require or otherwise allow states to cover LTSS under Medicaid. The Appendix provides a brief legislative history of Medicaid LTSS from Medicaid’s enactment and initial coverage requirements for institutional care through the evolution of HCBS options available to states.
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Long-Term Services and Supports: Overview and Financing

Long-Term Services and Supports: Overview and Financing

Date: April 4, 2013
Creator: Colello, Kirsten J.; Mulvey, Janemarie & Talaga, Scott R.
Description: This report provides an overview of Long-term services and supports (LTSS), including who needs LTSS, how need for LTSS is determined, and how much LTSS costs. The report also provides information on who the primary LTSS payers are, how much they spend, and what types of services are purchased.
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Public Health Service Agencies: Overview and Funding

Public Health Service Agencies: Overview and Funding

Date: November 12, 2013
Creator: Corby-Edwards, Amalia K. & Redhead, C. S.
Description: Within the Department of Health and Human Services (HHS), eight agencies are designated components of the U.S. Public Health Service (PHS): (1) the Agency for Healthcare Research and Quality (AHRQ), (2) the Agency for Toxic Substances and Disease Registry (ATSDR), (3) the Centers for Disease Control and Prevention (CDC), (4) the Food and Drug Administration (FDA), (5) the Health Resources and Services Administration (HRSA), (6) the Indian Health Service (IHS), (7) the National Institutes of Health (NIH), and (8) the Substance Abuse and Mental Health Services Administration (SAMHSA). This report gives a brief overview of each agency and summarizes its funding for FY2010 through FY2013, as well as its FY2014 budget request.
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Beverage Industry Pledges to Reduce Americans' Drink Calories

Beverage Industry Pledges to Reduce Americans' Drink Calories

Date: October 6, 2014
Creator: Dabrowska, Agata
Description: This report briefly covers recent initiatives by leading beverage companies to curb the obesity epidemic.
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Medicare Financial Status: In Brief

Medicare Financial Status: In Brief

Date: August 10, 2015
Creator: Davis, Patricia A.
Description: This report provides an overview on Medicare, discussing its various components and sources of funding. The report also examines projections for spending within the program.
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Medicare Financing

Medicare Financing

Date: September 19, 2013
Creator: Davis, Patricia A.
Description: This report provides an overview of how the Medicare program is financed, including a description of the Medicare trust funds and a summary of key findings and estimates from the 2013 Report of the Medicare Board of Trustees regarding 2012 program operations and future financial soundness.
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Medicare: Insolvency Projections

Medicare: Insolvency Projections

Date: September 19, 2014
Creator: Davis, Patricia A.
Description: This report focuses on the two separate trust funds that fund Medicare, the Hospital Insurance (HI) trust fund and Supplementary Medical Insurance (SMI) trust fund. Almost from its inception, the HI trust fund has faced a projected shortfall and eventual insolvency. Because of the way it is financed, the SMI trust fund cannot become insolvent; however, the Medicare Trustees continue to express concerns about the rapid growth in SMI costs.
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Potential Impact of No Social Security COLA on Medicare Part B Premiums in 2016

Potential Impact of No Social Security COLA on Medicare Part B Premiums in 2016

Date: October 20, 2015
Creator: Davis, Patricia A.
Description: This report provides an overview of Medicare Part B premiums, the relationship between the Social Security cost-of-living increase (COLA) and Part B premiums, and the potential impact of a projected 0% Social Security COLA in 2016 on Medicare premiums, based on recent projections by the Medicare Trustees.
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Medicare Primer

Medicare Primer

Date: April 24, 2012
Creator: Davis, Patricia A.; Binder, Cliff; Hahn, Jim; Morgan, Paulette C.; Mulvey, Janemarie; Talaga, Scott R. et al.
Description: This report provides an overview of Medicare, the nation's federal insurance program, which pays for covered health care services of qualified beneficiaries.
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Medicare Provisions in the Patient Protection and Affordable Care Act (PPACA)

Medicare Provisions in the Patient Protection and Affordable Care Act (PPACA)

Date: May 27, 2010
Creator: Davis, Patricia A.; Hahn, Jim; Morgan, Paulette C.; Stone, Julie & Tilson, Sibyl
Description: This report, one of a series of CRS products on PPACA and the Reconciliation Act, examines the Medicare related provisions in these Acts. Estimates from CBO on PPACA and the Reconciliation Act indicate that net reductions in Medicare direct spending will reach approximately $390 billion from FY2010 to FY2019.
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Overview of Health Care Changes in the FY2015 House Budget

Overview of Health Care Changes in the FY2015 House Budget

Date: April 16, 2014
Creator: Davis, Patricia A.; Mitchell, Alison & Fernandez, Bernadette
Description: This report summarizes the proposed changes to Medicare, Medicaid, and private health insurance as described in H.Con.Res. 96 and accompanying documents, including the committee report and Chairman Ryan's Path to Prosperity report.
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Medicare Primer

Medicare Primer

Date: March 31, 2016
Creator: Davis, Patricia A.; Talaga, Scott R.; Binder, Cliff; Hahn, Jim; Kirchhoff, Suzanne M. & Morgan, Paulette C.
Description: This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
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Medicare Primer

Medicare Primer

Date: September 10, 2014
Creator: Davis, Patricia A.; Talaga, Scott R.; Binder, Cliff; Hahn, Jim; Morgan, Paulette C.; Mulvey, Janemarie et al.
Description: This report provides an overview of Medicare, the nation's federal insurance program, which pays for covered health care services of qualified beneficiaries.
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Summary Cost Data for Health Plans Available in Maine's Exchange, 2014: Fact Sheet

Summary Cost Data for Health Plans Available in Maine's Exchange, 2014: Fact Sheet

Date: May 1, 2014
Creator: Elan, Nicholas; Fernandez, Bernadette & Mach, Annie L.
Description: This report discusses the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) that contains a number of provisions that may affect the individual health insurance market.
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Self-Insured Health Insurance Coverage

Self-Insured Health Insurance Coverage

Date: June 25, 2010
Creator: Fernandez, Bernadette
Description: This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.
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Eligibility and Determination of Health Insurance Premium Tax Credits and Cost-Sharing Subsidies: In Brief

Eligibility and Determination of Health Insurance Premium Tax Credits and Cost-Sharing Subsidies: In Brief

Date: March 23, 2016
Creator: Fernandez, Bernadette
Description: Certain individuals without access to subsidized health insurance coverage may be eligible for premium tax credits, as established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). This report examines these tax credits and their eligibility requirements, as well as cost-sharing subsidies.
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Health Coverage Tax Credit

Health Coverage Tax Credit

Date: April 2, 2015
Creator: Fernandez, Bernadette
Description: The report describes the expired eligibility criteria, as well as the types of health insurance to which the tax credit may have been applied. It discusses past federal and state roles in administering the HCTC program, and it summarizes analyses on the credit's effectiveness in reaching targeted populations and related equity and efficiency issues. In addition, the report includes a short discussion of relevant current law and summarizes statutory history of the HCTC program.
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The Health Coverage Tax Credit (HCTC): In Brief

The Health Coverage Tax Credit (HCTC): In Brief

Date: February 18, 2016
Creator: Fernandez, Bernadette
Description: This report describes the eligibility criteria for the Health Coverage Tax Credit (HCTC) and the types of health insurance to which the tax credit may be applied. The tax credit's purpose is to make the purchase of health insurance more affordable for eligible individuals. The HCTC has a sunset date of January 1, 2020. The report also briefly describes the administration of the HCTC program and receipt of the credit by eligible taxpayers; it concludes with a summary of the HCTC's statutory history.
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