Center on Budget and Policy Priorities
Improving Benefit
Access in States,
ACA Opportunities and
Challenges
Working Families Success Network Conference
Shelby Gonzales, Center on Budget and Policy Priorities
November 7, 2013
0
cbpp.org
Center on Budget and Policy Priorities
New Health Coverage Landscape in 2014
FPL
Unsubsidized
400%
300%
250%
Subsidized
185%
200%
133%
100%
Current Medicaid /
CHIP Eligibility
Children
Pregnant
Women
61%
Coverage
Gap
Expansion
37%
0%
Working
Parents
Jobless
Parents
Childless
Adults
Medicaid and CHIP coverage, based on 2012 eligibility levels in a typical state
Source: Kaiser Commission on Medicaid and the Uninsured
cbpp.org
Center on Budget and Policy Priorities
About Half the States Are Likely
to Expand Medicaid in 2014
As of October 30, 2013
2
cbpp.org
Center on Budget and Policy Priorities
Vision for Streamlined Enrollment
Multiple Ways
to Enroll
HEALTH
INSURANCE
$
Medicaid
CHIP
Exchange
Data
Hub
Single Application
for Multiple Health
Programs
Source: Kaiser Family Foundation
#
Use of Electronic
Data to Verify Eligibility
Dear ______,
You are
eligible for…
Real-Time Eligibility
Determinations
cbpp.org
Center on Budget and Policy Priorities
New Application Requirements Pose
Opportunities and Challenges
• New standards that can
provide key protections
• Multi-benefit
applications must be
approved
• A lot of new
information is
requested from
consumers
cbpp.org
Center on Budget and Policy Priorities
Most SNAP Households Will Have Members Eligible
For Medicaid Under Health Reform
Note: This Figure considers SNAP households that contain at least one member who is not elderly or receiving SSI. The
percentages shown here are the shares of those households in which the household members who aren’t elderly or on SSI will
be financially-eligible for Medicaid under the ACA’s Medicaid expansion.
Source: CBPP analysis of Census Bureau data.
cbpp.org
Center on Budget and Policy Priorities
States Have the Option to Administratively
Enroll SNAP Participants in Medicaid
• States can apply for a waiver (an easy waiver that
is processed quickly) to fast track eligibility for
SNAP participants:
– States identify SNAP applicants and participants that
can be fast-tracked
– Minimal additional work to complete the Medicaid
eligibility process:
• Consumers consent to enroll
• Citizenship can be verified electronically
cbpp.org
Center on Budget and Policy Priorities
States Taking the Option Are Seeing Impressive
Results
• 65,000 have
consented to
enroll in AR
• 52,000 have
consented to
enroll in WV
• 45,500 have
consented to
enroll in IL
• 67,000 have
consented to
enroll in OR
cbpp.org
Center on Budget and Policy Priorities
Connecting People to Health Benefits and More
• Buzz around health can be a
mechanism to enroll families in
other programs
• Systems can be designed to be
integrated or interoperable to
avoid duplication – look to 2015
• Community based assistance can
bridge systems that are siloed
• Consider setting and measuring
expectations for coverage, e.g.
100% of poor children enrolled in
SNAP and Medicaid.
cbpp.org
Center on Budget and Policy Priorities
Resources
•
CMS Guidance on Administrative Enrollment: CMS State Health Official Letter
Facilitating Medicaid and CHIP Enrollment and Renewal in 2014
http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SHO-13-003.pdf
•
CBPP Paper on SNAP Administrative Enrollment: State Medicaid Agencies Can
Now Easily and Efficiently Enroll Several Million SNAP Participants Who Are
Eligible for Medicaid http://www.cbpp.org/files/SNAPMedicaidStreamline.pdf
•
CBPP ACA Toolkit: Coordinating Human Services Programs with Health Reform
Implementation: A Toolkit for State Agencies http://www.cbpp.org/files/6-612health.pdf
•
CBPP Website on ACA Policies: Beyond the Basics
http://www.healthreformbeyondthebasics.org/
cbpp.org