While coverage and access to Medicaid and the Affordable Care Act’s (ACA) individual marketplaces are rooted in federal law, both programs are also shaped by policy choices at the state level. These decisions can be influenced by state demographics, budgets, and ideologies or politics. The resulting laws and guidance can greatly affect whether older adults or people with disabilities have access to the care they need to live healthy, independent lives.

The Centers for Medicare & Medicaid Services (CMS), the agency that oversees the Medicare program, recently proposed a rule to help deter Medicare Advantage (MA) plans from deceptively targeting people who are dually eligible for Medicare and Medicaid. If the proposals go into effect, dual eligibles could face less confusion in plan selection and may be less likely to enroll in a plan that does not meet their needs.

Last week, the Medicare Rights Center submitted comments in opposition to a proposed rule from the Social Security Administration (SSA) that would harm people with disabilities, especially people who are approaching age 65. The proposal would make the current problems in the SSA determination and review system even worse and put up additional barriers to people who already spend years trying to access the benefits they need because of their physical or mental conditions.

Today, the Trump administration released guidance to help states convert some of their federal Medicaid funding into a block grant. In exchange for accepting this capped funding, states will receive more power to cut care and restrict coverage.

This new structure, billed as a voluntary demonstration for states, can apply to funding for optional Medicaid populations: low-income adults under the age of 65 who wouldn’t otherwise be eligible for the program. This includes adults in the Medicaid expansion population, though non-expansion states that voluntarily cover other adults—such as low-income parents with incomes above the traditional Medicaid threshold and adults with dependent children—may also participate.

Last month, the Kaiser Family Foundation (KFF) released a series of charts that explain and compare various legislative proposals to lower prescription drug costs. Such proposals are in the limelight because many Americans identify drug pricing as a significant problem and support government action to address it. According to one KFF poll, high drug costs have kept 30% of Americans from taking their medicine as prescribed.

This week, the Center for Medicare Advocacy, a national nonprofit, released a new issue brief on an often-misunderstood aspect of coverage for people with chronic illness who need longer term care.

Just before the New Year, the Medicare Rights Center responded to a proposal that would damage the Medicaid program by allowing Tennessee to convert its Medicaid funding into a block grant. Our comments note that doing so would cause harm to older adults and people with disabilities, as well as the Medicaid program as a whole.

One year ago, in a deeply flawed ruling, a Texas judge found the portion of the Affordable Care Act (ACA)

This week, a bipartisan group of leaders from the U.S. House of Representatives Committees on Energy & Commerce and Ways & Means sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concerns with the redesigned Medicare Plan Finder (MPF). The letter points to errors that advocates and Medicare counselors experienced when using the new tool to help beneficiaries compare and select Medicare Advantage and Part D prescription drug plans during Fall Open Enrollment. In the letter, the leaders urge CMS to ensure that people with Medicare who relied on MPF information to choose a plan this year are held harmless and have the opportunity to make changes to their coverage in 2020.

A new data note from the non-profit Kaiser Family Foundation (KFF), however, reveals that very few people with Medicare end up switching plans during the fall. Among MA and PDP plan enrollees who did not receive low-income subsidies, fewer than 8% of people enrolled in MA plans chose to switch to another MA plan in 2016. The pattern is similar for standalone drug plans–just over 8% switched from one PDP to another. This could mean that beneficiaries have reviewed and are happy with their coverage, but it might highlight a more troubling reality– people may not know they can switch plans or may find the process of comparing plan options too burdensome.