he Affordable Care Act and the final Medicaid and Exchange regulations issued in March 2012 contemplate: real-time eligibility determinations; coordinated information technology eligibility systems across Insurance Affordability Programs; and, a simplified enrollment pathway for applicants that relies on electronic database verification coupled with self-attestation.
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 State Milestones document, prepared by Manatt Health Solutions, identifies critical Affordable Care Act (ACA) implementation milestones states are striving to achieve by the end of 2012.
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).
On March 12, 2012, the Department of Health and Human Service (HHS) issued final and interim final rules governing the Establishment of Exchanges and Qualified Health Plans; and Exchange Standards for Employers under the Patient Protection and Affordable Care Act (ACA).
Under the Affordable Care Act (ACA) much of the expanded coverage will be provided through health insurers offering products on the new health benefit exchanges (exchanges). By compensating issuers for the risks related to the individuals they enroll, provisions related to reinsurance, risk corridors and risk adjustment are designed to lessen the financial risk issuers and exchanges will face under the ACA.
Predicting the Effects of the Affordable Care Act: A Comparative Analysis of Health Policy Microsimulation Models
Microsimulation models were utilized throughout the legislative process that led to the passage of the Affordable Care Act, and these models continue to play a prominent role in understanding the likely effects of federal health care reform provisions on insurance coverage and cost at both the national level and, increasingly, within individual states.
The Affordable Care Act offers numerous opportunities to stabilize coverage and care for beneficiaries as their incomes fluctuate, and states can reduce the impact of churn between coverage programs with design and purchasing strategies that promote seamlessness.
The Affordable Care Act allows states to create their own state-based health insurance exchanges or to allow a federally facilitated exchange to operate in the state. Proposed rules from the Department of Health and Human Services (HHS) also allow a partnership model where the federal and state governments share in the execution of exchange functions.
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.