Issue Briefs | Apr 12, 2012

Creating Seamless Coverage Transitions between Medicaid and the Exchanges

Center for Health Care Strategies – Carolyn Ingram, Shannon M. McMahon, and Veronica Guerra

Under health reform, Medicaid will expand in 2014 to cover an additional 16 to 20 million beneficiaries. This population will include a significant percentage of childless adults with urgent and complex health care needs, who are likely to shift between subsidy programs over time. This brief, prepared by the Center for Health Care Strategies, draws from current state programs that have dealt with this challenge successfully. The experiences described herein can help states develop policies and procedures that foster seamless coordination of care during coverage transitions between Medicaid managed care organizations and qualified health plans in the exchanges. A companion matrix includes excerpts of sample contract language related to coverage transitions in existing programs.


Expert Perspectives

March 14, 2025

Recent Federal Marketplace Proposal Imposes New Requirements for States and Consumers

On March 10, 2025, the Centers for Medicare & Medicaid Services released a proposed regulation that makes several policy and operational changes to the Affordable Care Act Marketplaces and insurance rules. This expert perspective reviews provisions of the proposed rule to assess their impact on State-Based Marketplaces and state insurance regulators.

Medicaid Cuts and the States: Tracking State-Specific Estimates of the Impacts of Proposed Changes

Congress is considering a variety of federal policy changes that will have significant impacts on the Medicaid program, widely expected to reduce enrollment and federal Medicaid funding to states. A variety of state-level estimates have been released, which can be helpful for states as they consider how various policy proposals might impact their Medicaid programs. This expert perspective highlights state agencies that have estimated and quantified the potential impacts of various proposals on enrollment and spending. SHVS will continue to regularly monitor published estimates from states and update this expert perspective.