Harmonizing Eligibility, Enrollment and
Coverage: Can States Hit the Right Notes?
What ACA Means for States
Alice Weiss
Pr...
March 23 – ACA Becomes Law
Eligibility Transformation
Major Medicaid Eligibility Expansion
Streamlined Medicaid Eligibility Test
MAGI (with Medicaid ...
Streamlined Enrollment
Single Application Form for All Programs
Minimum Documentation Standard
Application Online, By Phon...
New Coverage Imperative
Individual Mandate
Children Must Be Enrolled When Parents Enroll
Exchange Coverage Options
Consume...
Unprecedented Challenges…
Financial and Political
Complexities of New Rules
Systems Upgrades
Local Administration
Culture ...
… and Opportunities
Paradigm Shift Rewards for States, Consumers
System Reform Goals Within Reach
Quality/Provider Payment...
Questions?
Alice Weiss
Program Director, NASHP
Deputy Director, Maximizing Enrollment for Kids
1233 20th Street NW, Suite ...
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Eligibility Enrollment Overview: What ACA Means for States

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Eligibility Enrollment Overview: What ACA Means for States

  1. 1. Harmonizing Eligibility, Enrollment and Coverage: Can States Hit the Right Notes? What ACA Means for States Alice Weiss Program Director, NASHP NASHP 23rd Annual State Health Policy Conference New Orleans, LA October 5, 2010
  2. 2. March 23 – ACA Becomes Law
  3. 3. Eligibility Transformation Major Medicaid Eligibility Expansion Streamlined Medicaid Eligibility Test MAGI (with Medicaid “point in time’ and “countable sources of income rules”) Subsidized Coverage Through Exchanges More Stringent Regulation of Private Coverage MOE for Current Medicaid and CHIP Eligibility
  4. 4. Streamlined Enrollment Single Application Form for All Programs Minimum Documentation Standard Application Online, By Phone, In Person, By Mail “No Wrong Door” “Screen and Enroll” Promotes Seamless Coverage, Transitions Presumptive Eligibility Option
  5. 5. New Coverage Imperative Individual Mandate Children Must Be Enrolled When Parents Enroll Exchange Coverage Options Consumer Assistance >> Paradigm Shift Towards Universal Coverage
  6. 6. Unprecedented Challenges… Financial and Political Complexities of New Rules Systems Upgrades Local Administration Culture Change Rapid Pace of Change
  7. 7. … and Opportunities Paradigm Shift Rewards for States, Consumers System Reform Goals Within Reach Quality/Provider Payment Vertical/Horizontal Integration of Eligibility Systems Changes to Local/State Relationship Health Disparities Moving the Needle on Uninsured
  8. 8. Questions? Alice Weiss Program Director, NASHP Deputy Director, Maximizing Enrollment for Kids 1233 20th Street NW, Suite 303 Washington, DC 20036 202-903-0101 aweiss@nashp.org

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