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Thursday, May 23, 2013

5 Great New Ways for States to Help People Get (and Keep) Medicaid Coverage

Sarah Bagge

Staff Writer

On May 17, the Centers for Medicare and Medicaid Services released a list of five great options states can use to ensure that low-income people get and keep Medicaid coverage when the new simplified, streamlined enrollment system opens in October 2013. (It’s important to note that those determined eligible for Medicaid before the end of the year won’t receive benefits until January 2014, unless they are currently eligible for Medicaid.) As states attempt to enroll millions of new applicants in coverage, the following options will make it easier for them to ensure people get covered:

  1. Make an early switch to the new way of determining eligibility. The Affordable Care Act calls for a new eligibility determination system and one streamlined application for Medicaid, CHIP, and the premium tax credits available to help people purchase coverage in state health insurance marketplaces. This application process will be available for states to use in October 2013 to start signing people up for coverage that will start in January. However, some of those who apply for coverage from October through December will already be eligible for Medicaid and do not need to wait until January to get covered. Previously, states would have needed to keep using their old applications to determine eligibility for this group of applicants. This option allows states to make an early switch to exclusively using the new application. 
  2. Push back Medicaid renewals. As the word gets out about new coverage options under the Affordable Care Act at the end of this year and beginning of next year, states can expect a flood of new applications. This will be on top of the work states already do helping those who currently receive Medicaid renew their coverage once a year. States can push the requiredrenewal dates for those already enrolled in Medicaid coverage until after the extremely busy open enrollment period is over on March 31, 2014, so that they can focus on new applicants at the very beginning of the year.
  3. Enroll people in Medicaid using SNAP information. SNAP (Supplemental Nutrition Assistance Program, formerly called food stamps) benefits are available to people with incomes below 130 percent of the federal poverty level ($30,600 for a family of four). Because the Medicaid eligibility level is 138 percent of poverty ($32,500 for a family of four) for all children and for adults in states that expand Medicaid, most people receiving SNAP will also be eligible for Medicaid. States can use the information they already have for SNAP recipients to enroll eligible people in Medicaid. Using the SNAP information, states could, for example, send an eligible SNAP participant a Medicaid card and ask her to activate it if she’d like to receive Medicaid.
  4. Use information on children’s eligibility to enroll parents. The majority of states already offer Medicaid coverage for kids in families with incomes of up to 133 percent of poverty ($31,300 for a family of four). States can use the information they already have about a child’s family income to determine the eligibility of parents and provide them with an easy way to enroll.
  5. Provide 12-month continuous eligibility for adults. Since eligibility for coverage in Medicaid depends on a person’s income, changes in income throughout the year can mean that people are eligible for Medicaid in some months but not in others. This is sometimes referred to as “churning.” Churning can disrupt the care people receive by requiring them to switch coverage and change providers. It also raises administrative costs for states that have to disenroll and re-enroll people when changes in their income cause changes in eligibility. Continuous eligibility ensures a full year of coverage even with income changes. Most states already use continuous eligibility to keep some or all kids enrolled in Medicaid or CHIP. States can do the same for adults enrolled in Medicaid.

Millions of Americans will be newly eligible for coverage starting on January 1, 2014. States can use these exciting new options to make sure enrollment goes smoothly and maximize the number of Americans who are able to get and keep coverage.