Paving a Health Coverage Enrollment Superhighway
Upcoming SlideShare
Loading in...5

Like this? Share it with your network


Paving a Health Coverage Enrollment Superhighway






Total Views
Views on SlideShare
Embed Views



3 Embeds 140 137 2 1



Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

Paving a Health Coverage Enrollment Superhighway Presentation Transcript

  • 1. Paving a Health Coverage EnrollmentSuperhighway: Bridging State GapsBetween 2014 and TodayAlice M. Weiss, JDCo-Director, Maximizing EnrollmentProgram Director, NASHPFebruary 3, 2011
  • 2. 2Overview  ACA’s Vision: An Enrollment Superhighway  State Gaps and Challenges in Streamlining Enrollment  Bridging State Gaps to 2014  Conclusion
  • 3. 3 ACA’s Vision: An EnrollmentSuperhighway
  • 4. 4 ACA’s Enrollment VisionTransformation from: …To:  Welfare-Era   Modern  Burdensome   Easy to Use   Seamless  Disconnected   Interconnected  Complex   Simple  Paperwork-intensive   Technology-Enabled
  • 5. 5Gaps and Challenges for States
  • 6. Gaps and Challenges for States: 6 Consumer Experience Welfare Era Approach Despite De-linking Customer Service Demands Assistance/Human Touch Accessibility Needs – Language, Disability, Literacy Different ACA Enrollment Rules Based on Medicaid-eligibility and Immigration Status Risk of Coverage Gaps
  • 7. 7Gaps and Challenges for States:Consumer ExperienceSource: Congressional Budget Office.  “Recent Trends in the Variability of Individual Earnings and Household Income.”  June 2008.
  • 8. Gaps and Challenges for States: 8 Eligibility and Enrollment Policy   Streamlined Enrollment Policies   New Coverage Paradigm   Major Eligibility Expansions   Different Eligibility Rules for Medicaid vs. Exchanges   Separate Rules for MAGI/Non-MAGI Populations   Need to Track Newly Eligibles for Increased FMAP   State/Federal Eligibility Policies Conflict with ACA IntentPhoto courtesy of Southern Institute on Children and Families
  • 9. 9 Gaps and Challenges for States: Technology and Infrastructure Limited Online/Phone Enrollment Existing Eligibility Systems Often:   Outdated   Disconnected   Shared   Redundant Technology Literacy Challenges Procurement, Legislative Oversight Speedy Implementation Timeframes Financing
  • 10. 10 Gaps and Challenges for States: Governance and Administration Political Leadership Siloed Agency Work Culture Change Imperative Role of Local Agencies Horizontal Integration of Human Service Programs
  • 11. 11 Bridging the GapHelping States Reach 2014
  • 12. Bridging the Gap: 12 Consumer Experience Adopt Technologies to Support Consumer Connections Enable Consumer Assistance and Engagement Facilitate Coverage Transitions Ensure Accessibility for Diverse Populations
  • 13. Bridging the Gap: 13 Eligibility and Enrollment Policy Simplify Processes and Policies Minimize Data Collection; Increase Data- Sharing Review and Address Policy Conflicts Support Agency/Caseworker Culture Change
  • 14. Bridging the Gap: 14 Technology and Infrastructure Pursue New System Upgrades Through Federal Guidance Evaluate Technology Needs and Available Resources Pursue Economies of Scale
  • 15. Bridging the Gap: 15 Governance and Administration Identify State Priority Opportunities in Reform Invest in Multi-Agency Collaboration Develop Inventory of Local Functions to Inform Discussion of Future Local Roles Choose Degree of Integration Between Health and Human Service Programs
  • 16. 16 ConclusionStates at Crossroads:  Major challenges, changes needed  Opportunities for transformative change  State investment, leadership, planning critical  Federal support and oversight also essential  “Superhighway” within reach