Health care coverage, from private insurance to employer-provided health care to public programs like Medicare and Medicaid, can have various impacts on people’s use of health care and, ultimately, their health and well-being.
School Medicaid is a lifeline for millions of students who depend on school health services to learn and thrive. Over the years, school Medicaid has expanded to reach more children. Yet despite this growth, school Medicaid programs continue to face persistent challenges including administrative burdens and funding uncertainties.
America’s children are getting sicker, with chronic and mental health conditions on the rise, trends worsened by the pandemic and felt most by underserved communities. Schools have become critical hubs for care, supported in part by Medicaid. In this three-part series, we’ll explore school Medicaid’s role and what’s at stake as policy changes, including H.R.1, threaten its future.
Medicare Advantage insurers made nearly 53 million prior authorization decisions in 2024, roughly 145,000 every day. Now, federal rules, bipartisan legislation, state laws, and a voluntary insurer pledge are all moving to reform the process. But while the reforms focus on how prior authorization works, the bigger question gets less attention: does it work?
HHS released a massive publicly available Medicaid provider-level dataset spanning six years of data (2018-2024) that features over $800 billion in claims as the Trump Administration pushes for transparency in its crusade against fraud.
For the first time at this scale, Medicaid coverage for many adults will be tied to documenting work or other qualifying activities. AcademyHealth examines what the evidence shows about coverage loss, employment effects, administrative burden, and the tradeoffs policymakers face as states prepare to implement the new requirement.
In an unprecedented move raising urgent concerns about the future of preventive care in the United States, the leadership of the U.S. Preventive Services Task Force has been removed, threatening the independent, evidence-based process that ensures millions of Americans can access life-saving screenings and services at no cost.
Medicaid work requirements set by HR 1 take effect on January 1, 2027, with exceptions for beneficiaries considered medically frail. A recent JAMA Health Forum paper authored by Medicaid Medical Directors outlines crucial clinical considerations for states implementing these exemptions.
Millions of insured Americans are struggling to afford the care they're already paying for. A major new proposal would ban prior authorization, cap hospital prices, and limit insurer profits. AcademyHealth breaks down what the evidence actually supports.
Researchers from Columbia University Mailman School of Public Health, Icahn School of Medicine at Mount Sinai, and SUNY Albany studied the impact of continuous Medicaid enrollment on postpartum women nationally and in three states with contrasting Medicaid policies.
With the ACA premium tax credits expiring, some policymakers are proposing broadening access to health savings accounts (HSAs) as a fix-all to consumers’ health care affordability concerns, despite evidence to the contrary.