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Federal Priorities in Paving a Health Coverage Enrollment Superhighway
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Federal Priorities in Paving a Health Coverage Enrollment Superhighway


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  • 1. NASHP National Briefing: Paving a Health Coverage Enrollment Superhighway Joel Ario, Director Office of Health Insurance Exchanges Center for Consumer Information and Insurance Oversight February 3, 2011
  • 2. Vision for Eligibility and Enrollment  Partnership with States   Continued partnership with states to identify best practices and challenges to developing seamless eligibility and enrollment systems  Seamless, coordinated process   Single, streamlined application for all coverage programs   Centralized system which integrates eligibility and enrollment functions for Medicaid, CHIP, Basic Health Program and the Exchange   Real-time verification of applicant information  Customer-centric   Presents clear, accurate information on coverage options to support informed choices   Easy to navigate  Access to affordable health coverage options   Lowers barriers to financial assistance for coverage and ensures accurate determinations of eligibility
  • 3. Vision for Eligibility and Enrollment  Strong consumer protections   Secure data systems to collect and verify applicant information   Accurate eligibility determinations and enrollment  Feasibility   Policy and guidance that reflects available resources and leverages current systems where appropriate but promotes greater system efficiency  Minimal consumer burden   Simplified eligibility requirements across coverage programs   Coordination between coverage programs   Uses existing and new data systems to verify enrollment and eligibility in real-time with minimal paperwork
  • 4. Grant Opportunities for States  Planning Grants - Awarded in September 2010   Funding to States for planning activities related to establishing Exchanges   HHS has already awarded $49 million of this funding to 48 States and DC  Early Innovator IT Grants – FOA released October 2010   Funding to develop the key supporting capabilities for the Exchange and build universally essential components for state Exchange IT systems  Establishment Grants – FOA released January 2011   Funding to help states continue work on building their Exchanges
  • 5. Guidance and Technical Assistance  Regulations and guidance forthcoming  Facilitating state-to-state peer learning through grantee conferences and other strategies   Exchange Planning Grantee Meeting- Dec 2010   Technical Working Groups
  • 6. Moving Toward 2014  Priority on modernizing the Medicaid program and integrating eligibility and enrollment functions   Integration has many incentives and benefits  States lead the way in implementation   States have a wealth of experience in eligibility and enrollment   Looking for best practices to share with federal, state, local partners   Help us identify key issues and pitfalls regarding implementation