In the absence of federal legislation, states are actively seeking 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 to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.
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.