June 2020 Report to Congress on Medicaid and CHIP

MACPAC’s June 2020 Report to Congress on Medicaid and CHIP contains six chapters addressing some fundamental challenges facing Medicaid: improving integration of care for low-income people over age 65 and people with disabilities who are dually eligible for Medicaid and Medicare; ensuring that Medicaid is the payer of last resort when its beneficiaries also have coverage from another insurance program; and addressing concerns about high rates of maternal morbidity and mortality.

As the June report went to print, the country was marshalling its resources to confront the COVID-19 pandemic. Although this report reflects a body of work that the Commission developed prior to the public health emergency, the concerns it raises remain relevant. Issues affecting dually eligible beneficiaries, and pregnant women and their infants in particular may be of even heightened concern during the pandemic, and the issues affecting these populations will continue to require policymakers’ attention when the pandemic is over.

Chapter 1 discusses how to better integrate Medicaid and Medicare benefits to improve the care experience and health outcomes for the 12.2 million individuals who are dually eligible for both programs.
Chapter 2 offers the Commission’s analysis and initial recommendations on how to encourage enrollment of more dually eligible beneficiaries in integrated care models, increase the availability of integrated products, and reach greater levels of integration.
Chapter 3 offers a recommendation to increase enrollment in the Medicare Savings Programs, which are run by state Medicaid agencies to cover copayments and premiums for low-income Medicare beneficiaries.
Chapter 4 addresses Medicaid’s statutory role as the payer of last resort, with two recommendations to keep Medicaid from bearing costs that are the responsibility of the Department of Defense.
Chapter 5 examines increasing mortality and morbidity among pregnant and postpartum women. Although these trends are not limited to Medicaid, poor outcomes for many women and infants could be addressed through Medicaid policy.
Chapter 6 specifically looks at the effects of substance use disorder on pregnant and postpartum women and their infants.

Chapters: