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