Templates & Toolkits | Oct 16, 2012

Assessment of Current Coverage Programs and Future Options

Manatt Health Solutions

This template, prepared by Manatt Health Solutions, is intended to assist states in evaluating the options with respect to transitioning certain Medicaid and state-funded populations and programs into a post-ACA coverage environment with Medicaid eligibility for non-disabled adults under age 65 (potentially) expanded to 133% of the FPL and tax credits and cost sharing reductions available to individuals between 133% and 400% of the FPL (or between 100% and 400% in a non-expansion state).  The template suggests populations and programs that may be eligible to transition into the new adult Medicaid group or the Exchange, but each state will want to create a state-specific list of programs.  With respect to each of the populations or programs eligible to transition, the template suggests nine factors for consideration, ranging from the difference in covered benefits and consumer cost-sharing to the impact on state financing and the administrative complexity of maintaining or eliminating the program.  Finally, the template rolls up the considerations and lays out the possible decisions: maintain the program for some or all consumers; transition some or all consumers to the Medicaid new adult group; or, transition some or all consumers to the Exchange.

This template was rolled out by Manatt at the “Introduction to the State Health Reform Assistance Network” session at the 25th National Academy for State Health Policy Meeting on October 15, 2012. The slides from this presentation can be accessed here.

 

 


Expert Perspectives

October 11, 2024

CMS Offers New Details on Account Transfer 2.0

The Center for Medicaid and CHIP Services (CMCS) explained the transition to “Account Transfer 2.0” (AT 2.0) in a CMCS Informational Bulletin (CIB) released on October 10, 2024. The CIB indicates significant federal investment in improving the process of transferring consumer application information between state Medicaid and CHIP agencies and the Marketplace in the states using the federal platform. This expert perspective reviews the CIB and highlights opportunities for states to improve account transfer data under the CIB.

CMS Solicits Comments on Medicaid/CHIP Reporting Templates for Mental Health and Substance Use Disorder Parity

On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.

September 27, 2024

States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits

On April 2, 2024, the Centers for Medicare & Medicaid Services offered a new option for states to update their essential health benefits (EHB) benchmark plan to require coverage of routine adult dental benefits. While there are multiple drivers of inequities in oral health, a primary barrier to accessing dental services is the cost of care, a barrier that can be reduced with dental insurance. This expert perspective provides an overview of the newly available flexibility and discusses considerations for states weighing whether to add a requirement that plans subject to EHB cover routine adult dental care.