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.
Ten Considerations for States in Linking Medicaid and the Health Benefit Exchanges
Center for Health Care Strategies – Carolyn Ingram, Suzanne Gore and Shannon McMahon
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. This brief, authored by the Center for Health Care Strategies, analyzes opportunities for linkages between public and private coverage, explaining that linkages should seek to streamline administration across programs and facilitate seamless transitions between programs. Continuity of benefits, providers and health plans is critical to ensuring seamless affordable coverage for exchange consumers. This brief outline an approach for states and continuity issues that should be considered while implementing ACA’s exchange and Medicaid expansion requirements.