As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.
Coverage Alternatives for Low and Modest Income Consumers
Manatt Health Solutions
To ensure a seamless system of coverage, the Affordable Care Act (ACA) requires a single streamlined application for all Insurance Affordability Programs (IAPs) and a coordinated process for IAP eligibility and enrollment. States looking beyond the eligibility and enrollment process can utilize this chart to explore different mechanisms to address the cost-sharing cliff in the Exchange and also to promote continuity of coverage and care as consumers transition across IAPs. The following chart, developed by Manatt Health Solutions, provides a side-by-side analysis of coverage alternatives under state and federal consideration including: the Basic Health Program (BHP); the Bridge Plan; Qualified Health Plan (QHP) Premium and Cost-Sharing Support; maintaining existing Medicaid expansions above 133 percent FPL; and Premium Assistance. These options are compared against subsidized QHP coverage available under the ACA.