Research suggested that state savings from premiums and cost-sharing in Medicaid and CHIP are limited, and that increases in premiums and cost-sharing can increase pressures on safety net providers.Ī review of recent studies continues to support earlier research on the impacts of premiums and cost-sharing among low-income populations. Studies also found that even relatively small levels of cost-sharing are associated with reduced use of care and increased financial burden. Research indicated that these effects are largest among those with the lowest incomes. What does the literature tell us about the effects of premiums and cost-sharing on low-income populations?Īn earlier literature review found that premiums serve as a barrier to obtaining and maintaining Medicaid coverage for low-income individuals, with those who lose coverage facing increased barriers to accessing care. In addition, as Congress considers options to provide coverage for people in the coverage gap, understanding the implications of premium requirements may help inform those options. Looking ahead, changing waiver policy under the Biden Administration could also impact the future of Medicaid premiums under Section 1115 waivers. #Medicaid out of pocket expenses how toAfter the PHE ends, states must determine whether and how to resume premium policies. Of the six states that had been implementing Section 1115 premiums prior to the PHE, three have continued to charge these premiums while the other three have temporarily waived or suspended these premiums.
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