What level of Medicaid enrollment does your state expect in 2014? Have you submitted an Implementation Advance Planning Document to CMS? Members of the State Refor(u)m community are asking for your insights.

In the discussion excerpts below, get a glimpse of the challenges your peers are facing, then follow the links to read more about their work, offer an idea, or see how others are responding.

On estimating Medicaid enrollment in 2014, from Joe Flores of Virginia:

"Now that states are starting to budget for the anticipated cost of the Medicaid expansion in FY 2014, can other states share what assumptions they are using for the take up rate for the newly eligible population? Are states assuming everyone will show up at the door on January 1, 2014 and be able to enroll in Medicaid?...What assumptions are states making about the take-up rate for [individuals that are currently eligible but not enrolled in Medicaid]?"
>> Read more and offer a response.

On Advance Planning Documents, from Megan Wood of Colorado:

"Colorado's Medicaid agency is working on an Implementation Advance Planning Document to CMS for Medicaid eligibility system development/modification to meet the requirements of the Affordable Care Act and is looking for examples. Do you have an approved, submitted, or draft IAPD?"
>> Go to the discussion to post your document, or indicate your shared interest in seeing other states' documents.

Colorado: Draft Essential Health Benefits Comments

This letter from the Colorado Division of Insurance and the Colorado Health Benefit Exchange responds to HHS's Essential Health Benefits Bulletin and subsequent guidance. The letter includes comments on states' flexibility in making adjustments to the benefits comprising the EHBP, and in conducting state-run assessments. States writing comments to HHS can compare their key concerns with those of Colorado, and learn how Colorado interpreted the Bulletin.
>> Is your state drafting comments? Upload them here.

Georgia: Health Insurance Exchange Final Report

This report from the Georgia Health Insurance Exchange Advisory Committee reviews the potential benefits of a small business marketplace, as well as the impact on the state of federally run individual and small-business exchanges. The report recommends the state adopt a small-business health insurance marketplace, relying on private-sector, free-market principles, outside the context of PPACA requirements. The benefits of this approach, the committee writes, include:

• Easing of administrative burdens
• Improving the range of health insurance choices
• Improving employee satisfaction

Guest bloggers this week report that "California's 'Bridge to Reform' 1115 Medi-Cal Waiver (adopted in November 2010) will have a significant and lasting impact on California's coverage rates and quality of care." They write that under the waiver, leaders at the local level have discretion to make important decisions across a range of areas, including coverage and service delivery.

>> Read the blog

Look for State Refor(u)m community members at your next health policy event. Many of you visited our booth last week at Health Action 2012, and these new users were among the many who signed up on the spot:

Jim Duffett, Illinois
Executive Director, Campaign for Better Health Care

Nadine Gousse, Florida
Senior Prosperity Coordinator, Catalyst Miami

Anthony Wright, California
Executive Director,
Health Access