To address churn, The Washington Health Care Authority intends to implement the Apple Health Plus program, a seamless approach for sustaining coverage and provider network connections when family members with Exchange coverage become eligible for Medicaid. Apple Health Plus is grounded in the former state sponsored Basic Health Plus program that historically offered a seamless system for coordinating eligibility and benefits for Basic Health and Medicaid enrollees.

Recent Urban Institute recommends several measures to reduce churning, including a measure to reduce churning by “encouraging or requiring the same plans to serve Medicaid and the exchange and to participate in individual and small group markets both inside and outside the exchange.