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Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
Academy health deleire_june_2010
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Academy health deleire_june_2010

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Presentation by Tom DeLeire at AcademyHealth 2010 ARM

Presentation by Tom DeLeire at AcademyHealth 2010 ARM

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  • Retention of autoenrollees qualitatively equal to retention of enrollees entering through more traditional means –IF– they aren’t subject to premium requirements
  • 1. Use the American Community Survey to aid in a thought experiment: would this be a good strategy to target low-income parents? 2. Varies across states, so we calculate state-by-state tallies of the number of low-income parents potentially captured via autoenrollment and what percent of these autoenrollees are uninsured vs. having private coverage 133% FPL (about $24,000 for a family of 3 in the contiguous US)
  • Transcript

    • 1. Getting Parents Enrolled in Medicaid: Lessons from Wisconsin‘s BadgerCare Plus Auto-Enrollment Process Thomas DeLeire Lindsey Leininger, Laura Dague, Shannon Mok, Donna Friedsam University of Wisconsin-Madison
    • 2. Health Care Reform
      • A key coverage component of the law is an expansion of Medicaid to 133% FPL
        • CBO estimates that roughly 50% of the increase in coverage will come from Medicaid expansion
      • Low-income parents represent an appreciable portion of the newly eligible population
        • 4.1 million or 34% of newly eligible adults
    • 3. Enrollment of Eligible Persons
      • Many eligible individuals do not enroll in Medicaid
        • 75% of uninsured children and 28% of uninsured parents are eligible for public insurance (Holahan et al., 2007)
      • Getting uninsured individuals enrolled quickly may be important for improving health (McWilliams et al., 2009)
    • 4. Auto-Enrollment Should be Considered for Health Reform Implementation
      • Outline
        • Wisconsin’s experience with auto-enrollment
        • National and state by state estimates of the number of parents that could be auto-enrolled
    • 5. The Launch of
      • WI’s BadgerCare+ : joint Medicaid & CHIP program
      • Massive reform effort launched in Feb. 2008
        • Eligibility expansion
        • Auto-enrollment
        • Simplification of enrollment and recertification processes
        • Aggressive marketing campaign
    • 6. Auto-Enrollment in Wisconsin
      • WI implemented a one-time “auto-conversion” effort immediately prior to BC+ program launch
        • Auto-enrolled 44,000 previously ineligible or pending applicants
          • Applied new program eligibility criteria to previously ineligible individuals for whom there was current administrative data
          • 92% of were siblings and/or parents of existing beneficiaries
    • 7. Auto-Enrollment in Wisconsin
      • Anyone who had a family member enrolled in state health programs in December 2007 or January 2008), or who had had a case closed 30 days prior were auto-enrolled
      • 44,000 auto-enrollees out of almost 70,000 individuals newly enrolled in the first month
    • 8. Kaplan-Meier Estimates of Disenrollment by Auto-Enrollment
    • 9. Auto-Converts vs. Other New February 2008 Entrants
    • 10. Auto-Enrollment Potentially Useful In Federal Reform
      • American Community Survey, 2008
      • Calculate the number of parents who would become newly eligible under 133% FPL eligibility
      • Calculate what fraction of these have children already on public insurance
      • Calculate what fraction of these are currently uninsured
    • 11.  
    • 12. Percent of Newly Eligible Parents Who Are Potential Auto-Enrollees
    • 13. Percent of Potential Auto-Enrollees with Private Health Insurance
    • 14. Conclusion
      • Auto-enrollment of parents
        • Should be feasible given many existing data systems
        • Has the potential to enroll 2.3 million parents immediately upon program expansion
        • Is target efficient as 75% of these parents are uninsured

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