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Issue Brief
September 2013

Everything You Need to Know about Understanding and Designing Medicaid Alternative Benefit Plans

This series examines the importance of creating Medicaid benefit packages that meet the needs of state residents. Under the Affordable Care Act, states that expand Medicaid are required to design their own set of benefits for those who are newly eligible for Medicaid. These sets of benefits are called Alternative Benefit Plans.

Federal guidelines specify what these plans must include, but each state has considerable flexibility in plan design. States can take advantage of this flexibility by providing newly eligible residents with coverage that's tailored to meet the needs of their residents and that's more comprehensive than what is required.

Advocates and state policy makers can use this series to explore which issues states should consider when designing Alternative Benefit Plans. Advocates can play a role by:

  • building the case for a strong Alternative Benefit Plan
  • encouraging states to monitor and evaluate Alternative Benefit Plans
  • advocating for improvements