On October 23rd, 2014, we updated our
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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
7Gaps and Challenges for States:Consumer ExperienceSource: Congressional Budget Office. “Recent Trends in the Variability of Individual Earnings and Household Income.” June 2008. http://www.cbo.gov/ftpdocs/95xx/doc9507/Frontmatter.1.2.shtml.
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 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for States: Technology and Infrastructure Limited Online/Phone Enrollment Existing Eligibility Systems Often: Outdated Disconnected Shared Redundant Technology Literacy Challenges Procurement, Legislative Oversight Speedy Implementation Timeframes Financing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 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 Bridging the GapHelping States Reach 2014
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
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
Bridging the Gap: 14 Technology and Infrastructure Pursue New System Upgrades Through Federal Guidance Evaluate Technology Needs and Available Resources Pursue Economies of Scale
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 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