In recent months, states have increasingly introduced proposals for individuals above Medicaid eligibility levels to “buy-in” to Medicaid or leverage the Medicaid program to strengthen coverage across the individual market and Medicaid. State Health and Value Strategies is tracking current state activity and has mapped out which states are pursuing a program and those that are establishing task forces to understand the impact of a Medicaid buy-in program.
Consumer Impact Analysis Presentation
Wakely Consulting Group – Julia Lerche
As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and could have tax liability implications. While marketplaces are attempting to make the renewal process as smooth as possible for consumers by facilitating auto-renewals into QHPs and, in the case of the FFM, rolling over 2014 APTCs into 2015, this approach could potentially be detrimental to some consumers, depending on factors such as income changes, premium variation, or a change in the benchmark plan. This slide deck was presented by Julia Lerche of Wakely Consulting Group on a Medicaid affinity group conference call facilitated by the State Network on August 5, 2014, along with a white paper describing the issue, and provides several scenarios in order to explain the potential impact of rate changes on consumers. This information can be utilized to inform modifications to carrier notices and communication planning (messaging, targeted outreach, education) for consumers, navigators/assistors and the media.