ACA Propels States to Adopt Best Practices in Simplification and Alignment – Say Ahhh! A Children’s Health Policy Blog

IMG_0764.JPGand Jennifer Mezey, National Women’s Law Center

Simplification and alignment of policies for children in Medicaid and CHIP have helped states fill the gap in private insurance and achieve record levels of coverage for 90% of our nation’s children. These lessons are carried forward in the Affordable Care Act’s (ACA) expansion of coverage through Medicaid and the Exchanges. The ACA envision a customer-friendly, paperless system where coverage options are aligned, enrollment processes are simplified, and technology is used to verify eligibility.

To dig into these issues more deeply, we prepared this issue-brief that reports on current state efforts to align and simplify coverage for children and parents in Medicaid and how the ACA moves states toward a more coordinated system of family-based coverage. Simplifying and aligning coverage options will make it easier to build the critical information technology (IT) that will support a first-class consumer experience in accessing health coverage as part of the 2014 expansion of coverage. It will also increase state administrative efficiency and promote accuracy and consistency in the eligibility decision process. But most importantly, it makes it easier for eligible children, parents and other adults to secure affordable health coverage.

As states move to 2014, there are steps they can take now to simplify and align coverage for children, parents, pregnant women, and other adults. These include:

  • Creating family-based applications, eliminating the asset test, and synchronizing one-year renewal dates for children and their parents.
  • Aligning the income counting rules for children and families under current law.
  • Providing online applications and making better use of data matches to verify income eligibility even before the federal “hub” is operational
  • Adopting presumptive eligibility for children and implementing procedures to support hospitals that elect to make presumptive eligibility determinations in 2014.
  • Adopting 12-month continuous eligibility and express lane eligibility for children.
  • Exploring §1115 waivers to extend 12-month continuous eligibility and implement express lane eligibility for parents and other adults.

In the coming weeks, we’ll be reviewing the recently released proposed regulations that address eligibility and enrollment in Medicaid and the Exchanges to see what new details emerge about these issues and policies. As always, we’ll share our thoughts here with you on Say Ahhh!.

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