The Medicaid expansion and the availability of subsidies in the health insurance exchange are the first steps in giving millions of lower-income Americans access to health coverage. However, estimates show that nearly half of adults eligible for Medicaid or exchange subsidies—28 million people—would experience income changes within one year that could cause a shift in eligibility between Medicaid and the exchange. read more
state of implementation
When states working on health reform think “Oklahoma,” they are thinking about a state pioneering eligibility and enrollment innovations and not the award-winning musical. In September 2010, Oklahoma launched the first real-time Medicaid eligibility and enrollment system in the nation, making the days of paper applications and long, cumbersome verification processes a thing of the past. Today, Oklahoma handles about 30,000-35,000 applications a month through an automated central rules engine and data exchange. read more
A hot topic for states pursuing their own health insurance exchanges is how to structure the navigator program. With an estimated 25 million-plus people newly eligible for coverage in 2014, navigators will play a major role in helping consumers learn about and choose health coverage. In fact, states running exchanges are required to include navigator programs, which are part of the ACA’s “no wrong door” approach to eligibility and enrollment. read more
Fans of the nineties television drama “The West Wing” might remember President Bartlett (Martin Sheen) often uttering the phrase, “What’s next?” to his staff, an indication that he was ready to move on to a new topic or activity. Simultaneously implementing national health reform and advancing their own health initiatives, states are immersed in efforts to transform their health care systems, so, like this fictional president, must constantly be asking “what’s next?” read more
Grab your bags, we’re road tripping out west to visit some newly established exchanges! Washington, Oregon, Colorado and Nevada have all established exchanges and appointed governing boards. These states are moving forward, making policy decisions on navigator programs and on market and plan rules. They are also focused on the nuts and bolts of establishing their new exchange businesses, including operations, planning, and procurement processes.
Navigators read more