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Issue Brief
November 2013

Medicaid Alternative Benefit Plans: What States Should Consider When Designing Coverage for the Expansion Population and the Role for Advocates

Alternative Benefit Plans offer states a great deal of flexibility, as well as an opportunity to provide people in the Medicaid expansion population with comprehensive coverage that meets their health care needs.

This brief looks at the issues that states should consider as they design a benefit plan for people who will be newly eligible for Medicaid. It discusses:

  • the four Medicaid coverage options states can use as the foundation when designing Alternative Benefit Plans
  • the areas where states have flexibility when designing Alternative Benefit Plans (apart from the minimum federal requirements)
  • why states should consider the health care needs of the Medicaid population
  • approaches to benefit design states can consider as they develop their Alternative Benefit Plans
  • the timeline for plan selection, approval, and modifications

The brief also outlines opportunities where consumer advocates can engage in the process, both during the initial benefit design and when making improvements to the plan, and it includes an advocates’ checklist.