AFHR-Keeping Coverage Continuous: Smoothing the Path between Medicaid and the Exchange

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May 20, 2011 the Alliance for Health Reform held a briefing entitled "Keeping Coverage Continious: Smoothing the Path between Medicaid and the Exchange." The discussion focused on a key design challenge for those tasked with implementing the ACA, how to manage the "churning" of individuals from Medicaid to subsidized care offered in the state health insurance exchange due to income flucuation? The briefing aimed to address these key questions:

  • What approaches are states and the federal government taking to minimize the disruption from churning?
  • Will people be able to keep their provider as they move across the Medicaid-exchange divide?
  • How can private insurers and Medicaid overcome possible technical and cultural barriers to a cooperative working relationship?
  • What issues must states consider as they establish “no wrong door” eligibility determination processes for Medicaid, CHIP and health insurance subsidies?

The Alliance for Health Reform and The Commonwealth Fund sponsored the briefing. Panelists included: Don Gregory, director of the Louisiana Medicaid program; Deborah Bachrach, former New York Medicaid director now with Manatt, Phelps & Phillips, LLP; and Pamela Short, Pennsylvania State University.