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.
On March 16, 2012, the Department of Health and Human Services (HHS) issued final and interim final rules codifying Medicaid eligibility and enrollment provisions of the Patient Protection and Affordable Care Act (ACA).
Laying the IT Foundation for 2014: Developing Infrastructure for Improved Eligibility and Enrollment Systems
One of the biggest challenges – and opportunities – for states as they strive to implement the Affordable Care Act’s (ACA) coverage expansions is the size and scope of technology solutions required to support exchanges in making eligibility determinations and enrolling consumers in coverage.
State Affordable Insurance Exchanges (exchanges) are at the core of the coverage reform in the Affordable Care Act (ACA). The exchanges establish a marketplace in which individuals and small employers can compare and select among affordable, quality health insurance options.
The Affordable Care Act (ACA) provides subsidized coverage options for individuals up to 400 percent of the Federal Poverty Level.
On August 12, 2011, the U.S. Department of Health and Human Services issued two sets of proposed rules focus on Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment procedures, as well as eligibility for exchanges, insurance affordability programs and Qualified Health Plans.
An estimated 27 million people will gain coverage through Medicaid or private qualified health plans via the new health insurance exchanges once the Affordable Care Act (ACA) is fully implemented in 2014. It is estimated that a significant percentage of those obtaining coverage will have income fluctuations that will change their eligibility status between public and private coverage options offered through the exchanges.