Eligibility & Enrollment
-
CMS Releases Guidance on Ensuring a Smooth Transition for ‘Stairstep’ Kids
By Wesley Prater As I discussed in a previous blog, Section 2001(a)(5)(B) of the Affordable Care Act aligns the minimum eligibility level for children across all age groups. Thus, some states will need to transition children from coverage in their separate CHIP programs to coverage in Medicaid on January 1, 2014. The provision is intended…
-
How Will Immigrants Fare Under Health Reform? Putting Out the Welcome Mat & Encouraging Enrollment, Part II
By Dinah Wiley In Part I of this blog series, I noted that immigrants have unique concerns about signing up for health insurance, and are less likely than citizens to do so, and that blog addressed confidentiality concerns of immigrant families. The privacy concerns are paramount, yet a mixed-status family will also wonder if they…
-
Kaiser Report Finds More Than 5 Million Will Fall Into Coverage Gap Created by States Failing to Expand Medicaid
A federally-funded Medicaid option for more uninsured adults is an important cornerstone of the Affordable Care Act, however, an estimated 5,161,820 uninsured individuals will be left behind because they live in states that have not yet accepted the Medicaid expansion option. Those who fall into the gap earn too much to qualify under their state’s…
-
New Urban Paper Compares Eligibility for Assistance Across States
By Martha Heberlein Some exciting new state-by-state data from the Urban Institute gives states a better sense of how many people might be eligible for and enroll in the expanded coverage options under the ACA, finding that more than 25 million uninsured are eligible for some sort of assistance securing coverage. As expected, there’s large…
-
How Will Immigrants Fare Under Health Reform? Encouraging Enrollment
By Dinah Wiley Immigrants who are eligible for Medicaid and CHIP, compared to their citizen counterparts, are less likely to sign up for health coverage. Why is this so? It’s true that newcomers to the U.S. are more healthy than native-born Americans, for a few years at least. Yet when immigrants are offered private insurance…
-
Medicaid.Gov Posts State Profiles, Verification Plans and MAGI Eligibility Levels
Happy open enrollment day! If you are looking for detailed information on your state’s plans for implementing the new streamlined application and ACA eligibility requirements, check out this link, then click on your state. Although some of the information is in progress for some states, it’s great to have a wealth of information in one…
-
Health Insurance for Immigrant Families
The webinar examines changes in health reform law and regulations that affect the eligibility of immigrants and the access barriers they face, particularly when part of mixed-status families. It also looks at which rules have not changed, showing a snapshot of the landscape of coverage options for immigrant families as of 2013. Download the recording
-
How Have Immigrant Families Fared (So Far) Under Health Reform?
By Dinah Wiley Immigrant families are among the most in need of health reform, with high rates of uninsurance and poverty despite employment rates as high as those of citizen-headed households. How will these families fare under health reform? Though a few federal rules are still undecided, we can safely say that many non-citizens will…
-
Update: 12-Month Continuous Eligbility Can Improve Continuity of Coverage
Last month, I wrote a blog post on a report released on the continuity of coverage in Medicaid. This week, the Association for Community Affiliated Plans released an updated report on why continuity of coverage in Medicaid matters. Continuity of coverage reduces cost and is the first step in getting quality health care. The typical…
-
12-Month Continuous Eligibility Can Improve Continuity of Coverage
Back in May, Martha Heberlein wrote about 5 strategies that CMS is offering to help states face the task of enrolling large numbers of people on January 1, 2014. One of these strategies, 12-month continuous eligibility for adults, is key to improving the continuity of Medicaid coverage, according to a paper published by the Association…
-
CMS Issues More Guidance on Stairstep Kids
By Wesley Prater As Tricia Brooks highlighted in her previous blog, CMS recently released a set of FAQs to provide more guidance on telephonic applications, MAGI-based eligibility, Medicaid and CHIP eligibility, and the 75/25 Federal matching rate. The FAQs included more guidance about the transition of children ages 6-18 up to 133% of the FPL…
-
Nevada and West Virginia Latest to Remove CHIP Waiting Periods
As we have blogged before we were hoping that CMS was going to prohibit states operating separate state CHIP program from imposing waiting periods for children. But they didn’t, and the choice continues to fall squarely in the state’s purview. Last week we learned that two more states, Nevada and West Virginia, are now moving…
-
Tech Tuesday: HHS Provides Guiding Principles for Telephone Applications
“No wrong door,” a phrase coined to explain access to all the insurance affordability programs (Medicaid, CHIP and subsidized coverage through a Health Insurance Marketplace) through a single application process, is also often used to describe the different paths to enrollment. Beginning October 1, 2013, states are expected to allow individuals to apply online, over…
-
Hospitals Should Exercise the Option to Enroll Kids in Medicaid through Presumptive Eligibility
Among many other provisions, the Affordable Care Act (ACA) gives hospitals the prerogative to make Medicaid presumptive eligibility (PE) decisions, regardless of whether the state has previously implemented PE. Presumptive eligibility allows states to train specific “qualified entities,” such as health care providers, schools, government agencies and community-based organizations, to screen for eligibility and temporarily…
-
How Will Aligning Eligibility for Children in Medicaid Make Better Sense for Families and States?
By Wesley Prater The Affordable Care Act is most widely recognized for its expansion of affordable coverage to low-income parents and adults; however, a lesser-known feature of the ACA also helps children by aligning Medicaid coverage across families at 133% of the federal poverty level (FPL). Today, states must cover children under the age of…
-
Aligning Eligibility for Children: Moving the Stairstep Kids to Medicaid
A feature of the Affordable Care Act (ACA) that has not received a lot of attention requires that Medicaid cover children with incomes up to 133 percent FPL as of January 2014. Today, there are “stairstep” eligibility rules for children. States must cover children under the age of six in families with income of at…
-
CHIP Lock Outs May Leave Kids Without Premium Tax Credits, Too
By Joe Touschner As Tricia Brooks wrote last week, new rules set limits on how states handle lock out periods for children enrolled in CHIP. Several states impose a lock out period—a length of time when a child may not receive CHIP coverage—when families fail to pay CHIP premiums. The new rules limit lock out…
-
New Rules Set Limits on Locking Kids Out of Coverage for Nonpayment of Premiums
Thirty-three (33) states charge premiums or enrollment fees for children enrolled in Medicaid or CHIP, starting as low as 101% of the federal poverty level in CHIP. In the past, federal guidelines for dealing with premium grace periods and nonpayment of premiums were minimal, particularly in CHIP. It was not until CHIP was reauthorized in…
-
Children’s Medicaid/CHIP Crowd-Out Estimates by State
A new report by researchers at The Ohio State University College of Public Health finds that wealthier families who are eligible for public insurance are less likely to switch from private to public coverage than families earning less. The authors use ACS data and a regression discontinuity approach to obtain state estimates on how many…
-
New Kaiser/Urban Report Highlights the Costs of NOT Extending Medicaid
By Martha Heberlein As many states are nearing or have reached the end of their legislative sessions, it’s a good time to take stock of who will implement the Medicaid expansion and the far-reaching implications of these decisions. Twenty-four states have decided to move forward with the expansion, 21 will not, and 6 continue to…