Federal Requirements and State Flexibilities for Verifying Eligibility Criteria
he Affordable Care Act and the final Medicaid and Exchange regulations issued in March 2012 contemplate: real-time eligibility determinations; coordinated information technology eligibility systems across Insurance Affordability Programs; and, a simplified enrollment pathway for applicants that relies on electronic database verification coupled with self-attestation.
Creating Seamless Coverage Transitions between Medicaid and the Exchanges
Under health reform, Medicaid will expand in 2014 to cover an additional 16 to 20 million beneficiaries. This population will include a significant percentage of childless adults with urgent and complex health care needs, who are likely to shift between subsidy programs over time.
State Milestones for ACA Implementation
This State Milestones document, prepared by Manatt Health Solutions, identifies critical Affordable Care Act (ACA) implementation milestones states are striving to achieve by the end of 2012.
Overview of Final Medicaid Eligibility Regulation
On March 16, 2012, the Department of Health and Human Services (HHS) issued final and interim final rules codifying Medicaid eligibility and enrollment provisions of the Patient Protection and Affordable Care Act (ACA).
Overview of Final Exchange Regulations
On March 12, 2012, the Department of Health and Human Service (HHS) issued final and interim final rules governing the Establishment of Exchanges and Qualified Health Plans; and Exchange Standards for Employers under the Patient Protection and Affordable Care Act (ACA).
Analysis of HHS Final Rules On Reinsurance, Risk Corridors And Risk Adjustment
Under the Affordable Care Act (ACA) much of the expanded coverage will be provided through health insurers offering products on the new health benefit exchanges (exchanges). By compensating issuers for the risks related to the individuals they enroll, provisions related to reinsurance, risk corridors and risk adjustment are designed to lessen the financial risk issuers and exchanges will face under the ACA.
Predicting the Effects of the Affordable Care Act: A Comparative Analysis of Health Policy Microsimulation Models
Microsimulation models were utilized throughout the legislative process that led to the passage of the Affordable Care Act, and these models continue to play a prominent role in understanding the likely effects of federal health care reform provisions on insurance coverage and cost at both the national level and, increasingly, within individual states.
Strategies for Building Seamless Health Systems for Low-Income Populations
The Affordable Care Act offers numerous opportunities to stabilize coverage and care for beneficiaries as their incomes fluctuate, and states can reduce the impact of churn between coverage programs with design and purchasing strategies that promote seamlessness.
Risk Adjustment and Reinsurance: A Work Plan for State Officials
Under the Affordable Care Act (ACA) much of the expanded coverage will be provided through health insurers offering products on the new health insurance exchanges. To ensure robust markets, exchanges must have in place processes for mitigating the financial risk to insurers associated with enrolling individuals with diverse health care needs.
Federally-Facilitated Exchanges and the Continuum of State Options
The Affordable Care Act allows states to create their own state-based health insurance exchanges or to allow a federally facilitated exchange to operate in the state. Proposed rules from the Department of Health and Human Services (HHS) also allow a partnership model where the federal and state governments share in the execution of exchange functions.