Medicaid

Managed Medicaid plans have gone from above-target profit margins during the pandemic-era enrollment boom to aggregate underwriting losses, with early 2025 data suggesting the losses aren’t slowing, according to a February analysis from Wakely. The consulting group analyzed MCO financial…

On Feb. 25, Centene offered CMS seven Medicaid reforms that would allow managed care organizations to take the reins in targeting fraud, waste and abuse in Medicaid. The letter called on CMS to: 1. Permit proactive payment suspensions without a…

State Medicaid budgets will shrink by $664 billion through 2034 as key provisions of the One Big Beautiful Bill Act (H.R. 1) take effect, with impacts varying by state depending on expansion status, reliance on provider taxes and the use…

CMS is freezing $259.5 million in federal Medicaid funding to Minnesota, citing unsupported or potentially fraudulent claims in the state’s program. “We have decided to temporarily halt certain amounts of Medicaid funding that are going to the state of Minnesota…

EmblemHealth is partnering with Mae Health, a digital platform that connects expectant mothers to culturally responsive doulas, according to a Feb. 24 news release shared with Becker’s. The collaboration will target EmblemHealth Medicaid members. Doulas can assist with education around…

One question was at the root of Aetna Better Health of Illinois’ recent partnership with Elektra Health, a virtual menopause care platform: “Where are we seeing healthcare needs popping up that don’t have a solution?” During an episode of the…

In a Feb. 11 budget proposal, Gov. Gretchen Whitmer laid out how she plans to secure $780.4 million to stabilize Medicaid.  Ms. Whitmer is aiming to bring in $232 million from tobacco, $73.6 million from vaping and non-tobacco nicotine products,…

Ten states have still not expanded Medicaid under the ACA. If those states were to move toward expansion, 2.3 million people would secure health insurance coverage. While Medicaid expansion has long been a possibility, there is still some room for…

In a Feb. 9 exchange with The Topeka Capital-Journal, Democratic Gov. Laura Kelly of Kansas appeared to acknowledge her lame-duck status regarding her attempts to achieve Medicaid expansion for the state, a longtime key item of her administration’s platform. “There’s…

Alameda Alliance for Health, a county-organized Medicaid managed care plan serving more than 400,000 members in Alameda County, Calif., is bracing for a potential 40% to 45% reduction in membership over the next three years as federal Medicaid cuts and…