improving benefit access in states, aca opportunities and challenges
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Center on Budget and Policy Priorities
cbpp.org1
Improving Benefit Access in States,ACA Opportunities
and ChallengesWorking Families Success Network
Conference
Shelby Gonzales, Center on Budget and Policy Priorities November 7, 2013
Center on Budget and Policy Priorities
cbpp.org
Children Childless Adults
Working Parents
JoblessParents
Pregnant Women
250% Subsidized
Unsubsidized
37%61%
New Health Coverage Landscape in 2014
0%
185%
Medicaid and CHIP coverage, based on 2012 eligibility levels in a typical stateSource: Kaiser Commission on Medicaid and the Uninsured
FPL
400%
100%133%
200%
300%
Current Medicaid / CHIP Eligibility
ExpansionCoverage Gap
Center on Budget and Policy Priorities
cbpp.org3
About Half the States Are Likely to Expand Medicaid in 2014
As of October 30, 2013
Center on Budget and Policy Priorities
cbpp.orgSource: Kaiser Family Foundation
Vision for Streamlined Enrollment
Dear ______,You are eligible for…
Real-Time Eligibility Determinations
DataHub
$
#
Use of Electronic Data to Verify Eligibility
MedicaidCHIP
Exchange
HEALTH INSURANCE
Single Applicationfor Multiple Health
Programs
Multiple Ways to Enroll
Center on Budget and Policy Priorities
cbpp.org
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
Center on Budget and Policy Priorities
cbpp.org
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.
Center on Budget and Policy Priorities
cbpp.org
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
Center on Budget and Policy Priorities
cbpp.org
States Taking the Option Are Seeing Impressive Results
• 65,000 have consented to enroll in AR
• 45,500 have consented to enroll in IL
• 67,000 have consented to enroll in OR
• 52,000 have consented to enroll in WV
Center on Budget and Policy Priorities
cbpp.org
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.
Center on Budget and Policy Priorities
cbpp.org
• 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/6-6-12health.pdf
• CBPP Website on ACA Policies: Beyond the Basics http://www.healthreformbeyondthebasics.org/
Resources
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