News for families planning care

Template Comments & Instructions: Changes to Medicare Eligibility for Immigrants in the Physician Fee Schedule Proposed Rule (opens Justice in Aging in a new tab)

Instructions Jump to the template letter. The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule within the CY 2027 Medicare Physician Fee Schedule to implement changes to Medicare eligibility for lawfully present immigrants. These eligibility changes were enacted as par…

Medicaid Coverage for Women (opens KFF · Medicaid policy in a new tab)

This data note presents key data points describing the current state of the Medicaid program as it affects women.

Public Charge Final Rule: What Advocates Need to Know (opens Justice in Aging in a new tab)

Transcript Denny Chan: Hi, everyone. Welcome to today's webinar brought to you by Justice in Aging. The webinar is about the Public Charge Final Rule: What Advocates Need to Know. So thank you so much for tuning in today, whether you're tuning in live or watching the recording and reviewing the mate…

The Medicare GLP-1 Discount Has One Big Catch: Some Sick Patients Don't Qualify (opens KFF Health News · Aging in a new tab)

The new Medicare GLP-1 Bridge program promises eligible beneficiaries access to popular weight loss drugs for as little as $50 a month. But for some, having the very medical conditions these drugs are approved to treat means they don't qualify for the discount.

Status of State Medicaid Expansion Decisions (opens KFF · Medicaid policy in a new tab)

This page displays an interactive map of the current status of state decisions on the Affordable Care Act's Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.

Analysis: At Least 37 States Have Medicaid State Directed Payments for Hospital Services That Could Be Reduced by the 2025 Reconciliation Law Limits (opens KFF · Medicaid policy in a new tab)

An estimated $60 billion in federal Medicaid spending in 37 states (including the District of Columbia) would likely exceed new federal limits on state directed payments for hospital services once fully implemented, a new KFF analysis finds. States with the biggest potential reductions in Medicaid p…

At Least 37 States Have Medicaid State Directed Payments for Hospital Services That Could Be Reduced by the 2025 Reconciliation Law Limits (opens KFF · Medicaid policy in a new tab)

This analysis estimates the number of states impacted by and the amount of current federal spending on Medicaid state directed payments for hospital services that exceeds the new limits established by the 2025 reconciliation law when fully implemented.

Optional Medicaid and CHIP Coverage for Lawfully Present Immigrant Children Could Mitigate Coverage Losses Due to 2025 Reconciliation Law (opens KFF · Medicaid policy in a new tab)

This brief provides an overview of health coverage of noncitizen children to provide greater insight into the potential role of Immigrant Children’s Health Improvement Act (ICHIA) coverage in limiting the 2025 reconciliation law's impact on coverage for lawfully present immigrant children.

Prior Authorization Metrics Provide New Insights into Insurer Practices, but Gaps Remain (opens KFF · Medicaid policy in a new tab)

This analysis of available 2025 prior authorization data finds insurers denied at least 1 in 8 standard requests for prior authorization across three insurance markets: Medicare Advantage, Medicaid managed care, and the federally facilitated ACA Marketplaces. Denial rates varied wide segments by ins…

Medicaid 101: Basics and Recent Changes (opens Justice in Aging in a new tab)

Transcript Tiffany Huyenh-Cho: Welcome to today's webinar, Medicaid 101: Basics and Recent Changes. My name is Tiffany Huyenh-Cho, and I'm the director of California Medicare and Medicaid Advocacy at Justice in Aging. And I'm joined by Gelila Selassie. Gelila is the Director of Health Advocacy at Ju…

The Facts About Medicare Spending (opens KFF · Medicare policy in a new tab)

This interactive provides the facts on Medicare spending. Medicare, which serves 70 million people and accounts for 14 percent of the federal budget and 21 percent of national health spending, is at the heart of discussions about health expenditures and affordability. Explore data on enrollment grow…

From DC: The Fight to Protect Medicaid & Medicare, HUD LGBTQ+ Housing Protections, and More (opens Justice in Aging in a new tab)

In this week's edition: The Fight to Protect Medicaid & Medicare, HUD LGBTQ+ Housing Protections, and More. The post From DC: The Fight to Protect Medicaid & Medicare, HUD LGBTQ+ Housing Protections, and More appeared first on Justice in Aging .

Health Care Bills and Dually Eligible Individuals (opens Justice in Aging in a new tab)

Many individuals enrolled in both Medicaid and Medicare (“dually eligible individuals”) are eligible for assistance with Medicare out-of-pockets costs. Thus, any health care bills they receive should raise a red flag that they are being improperly billed or have lost their financial assistance. This…

Medicare Premium Bills and Dually Eligible Individuals (opens Justice in Aging in a new tab)

Medicare offers essential health care coverage for people with disabilities and older adults. Medicare can also be expensive, with premium bills reaching hundreds of dollars each month. Most individuals enrolled in both Medicaid and Medicare (“dually eligible individuals”) should have premiums cover…

How ABLE Accounts Work with Supplemental Security Income (SSI) (opens Justice in Aging in a new tab)

Transcript Trinh Phan: Hello, and welcome to today's webinar on how ABLE accounts work with Supplemental Security Income, or SSI. Next slide. We're going to start with some logistics on the next slide. Everyone is on mute. We welcome your participation through the Q&A function in the Zoom contro…

CMS’s Decision to End Temporary Subsidies to Medicare’s Stand-Alone Drug Plans Could Mean Larger Premium Increases for Some Beneficiaries Next Year (opens KFF · Medicare policy in a new tab)

Without these extra subsidies in place for 2027, some Part D stand-alone drug plan (PDP) enrollees could see a larger premium increase for drug coverage next year than they’ve faced in recent years, though plan-specific premium amounts are not yet known. While some policymakers questioned the ration…

What Could Medicaid Work Requirements Mean for SSI Applicants? (opens KFF · Medicaid policy in a new tab)

Medicaid work requirements may make it more difficult for some SSI applicants to maintain coverage due to the added complexity of navigating the verification process for the medical frailty exclusion. KFF's policy analysis explains why SSI applicants are particularly at risk of going uninsured under…

The Supplemental Security Income (SSI) Resource Limit and Common Solutions (opens Justice in Aging in a new tab)

Supplemental Security Income (SSI) provides critical cash assistance for low-income older adults and individuals with disabilities to pay for housing, food, health care, transportation, and other essentials. Under the current rules, which were last updated in 1989, SSI has a resource limit of $2,000…

How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion? (opens KFF · Medicaid policy in a new tab)

This analysis estimates that 1.4 million uninsured individuals in the ten states without Medicaid expansion, including many working adults, people of color, and those with disabilities, remain in the "coverage gap," ineligible for Medicaid or for tax credits that would make coverage affordable throu…

Medicaid Work Requirements: Federal Outreach Requirements and State Plans (opens KFF · Medicaid policy in a new tab)

State Medicaid programs must inform people affected by new work requirements with federally required notices, and most states are planning other types of outreach, including phone calls, public ads, and social media posts. This brief describes the federal outreach requirements and state plans, as we…

Understanding New Medicaid Work Requirements Rules (opens Justice in Aging in a new tab)

Transcript Gelila Selassie: Hello everyone. My name is Gelila Selassie. I'm an attorney here at Justice in Aging. I'm here with my colleague Natalie Kean, and the webinar for today is regarding understanding the new Medicaid work requirement rules. So thank you all for being here today. Next slide.…

New Public Charge Policies Will Likely Lead to Decreased Enrollment in Medicaid and CHIP (opens KFF · Medicaid policy in a new tab)

Between 1.4 to 4.1 million Medicaid and CHIP enrollees living in a household with a noncitizen could disenroll due to public charge and other immigration-related fears.

Social Security Benefits for Older Adults (opens Justice in Aging in a new tab)

Transcript Kate Lang: Hello, everyone, and welcome to today's webinar presentation entitled Social Security Benefits for Older Adults Basics. I'm Kate Lang, Director of Federal Income Security on the Economic Security and Housing Team at Justice in Aging. And today I'm delighted to be joined by…

Title II Auxiliary and Survivor Benefits and Eligibility (opens Justice in Aging in a new tab)

What are Social Security Benefits? Social Security is a social insurance program under Title II of the Social Security Act, with benefits based on an individual’s work history. This program can provide auxiliary benefits for the worker’s spouse, children, and other dependents.[1]&#160…

Mitigating the Harms of Medicaid Work Requirements for Older Adults: Tools for State Advocates (opens Justice in Aging in a new tab)

States can help people keep their Medicaid coverage by reducing paperwork and allowing them to self-report health conditions and caregiving responsibilities as exemptions from work requirements. The post Mitigating the Harms of Medicaid Work Requirements for Older Adults: Tools for State Advocates a…

Thousands of Medicare Beneficiaries Thought Their Drug Plan Was Free. Then They Lost It. (opens KFF Health News · Aging in a new tab)

Thousands of people who had a Medicare drug plan with zero-dollar premiums last year got small premium increases this year — and didn’t know it. They were dropped from their coverage for failing to pay amounts as little as $8, and most can’t get it again until 2027.

Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate (opens KFF · Medicare policy in a new tab)

Two recent reports find that Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. When these decisions are appealed, they are frequently overturned,…

Nearly Four Million Medicare Beneficiaries Could Be Eligible for the Temporary Medicare GLP-1 Bridge Program Covering These Drugs for Weight Loss (opens KFF · Medicare policy in a new tab)

This news release highlights that a KFF analysis finds that 3.8 million Medicare beneficiaries met the criteria to be eligible for the new Medicare GLP-1 Bridge, based on claims data from 2023. The temporary program will provide coverage of three GLP-1 drugs used for weight reduction and weight mana…

Nearly Four Million Medicare Beneficiaries Met the Eligibility Criteria in 2023 for the Medicare GLP-1 Bridge (opens KFF · Medicare policy in a new tab)

Medicare has launched a temporary program covering GLP-1s for obesity for people with Medicare, known as the Medicare GLP-1 Bridge. This analysis estimates the number of Medicare Part D enrollees who could potentially qualify for the Bridge program by meeting all of the eligibility criteria, based o…

From DC: Take Action on HUD's LGBTQ+ Proposal, New Medicare Savings Bill, and more (opens Justice in Aging in a new tab)

In this week's edition: Take Action on HUD's LGBTQ+ Proposal, New Medicare Savings Bill, and more. The post From DC: Take Action on HUD's LGBTQ+ Proposal, New Medicare Savings Bill, and more appeared first on Justice in Aging .

Medicaid and CHIP Monthly Enrollment (opens KFF · Medicaid policy in a new tab)

The Medical Frailty Exemption from Medicaid Work Requirements: Key Takeaways from the CMS Interim Final Rule (opens KFF · Medicaid policy in a new tab)

This brief describes new guidance and potential challenges states will face in operationalizing the medical frailty exemption.

Medicare Advantage in 2026: Enrollment Update and Key Trends (opens KFF · Medicare policy in a new tab)

More than half (55%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage in 2026. To better understand trends in the growth of the Medicare Advantage program, this brief provides current information about enrollment, including by plan type and firm

Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries (opens KFF · Medicare policy in a new tab)

On May 22, the House passed a reconciliation bill, the One Big Beautiful Bill Act, which would partially pay to extend expiring tax cuts by cutting Medicaid. The Congressional Budget Office (CBO) estimates that the bill would reduce federal Medicaid spending by $793 billion over ten years and 10.3 m…

What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge (opens KFF · Medicare policy in a new tab)

This brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demonstration programs including the BALANCE Model, and potential impacts on beneficiaries and progr…

A New Medicare Option for Weight Loss Drugs: What Older Americans Should Know (opens KFF Health News · Aging in a new tab)

It may soon get easier for millions of people with Medicare to get discounted GLP-1 drugs for weight loss.