paving a health coverage enrollment superhighway
TRANSCRIPT
Paving a Health Coverage Enrollment Superhighway: Bridging State Gaps Between 2014 and Today
Alice M. Weiss, JD Co-Director, Maximizing Enrollment
Program Director, NASHP February 3, 2011
Overview
ACA’s Vision: An Enrollment Superhighway
State Gaps and Challenges in Streamlining Enrollment
Bridging State Gaps to 2014
Conclusion
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ACA’s Vision: An Enrollment Superhighway
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ACA’s Enrollment Vision Transformation from:
Welfare-Era Burdensome Disconnected Complex Paperwork-intensive
…To:
Modern Easy to Use Seamless Interconnected Simple Technology-Enabled
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Gaps and Challenges for States
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Gaps and Challenges for States: Consumer Experience
Welfare Era Approach Despite De-linking
Customer Service Demands
Assistance/Human Touch
Accessibility Needs – Language, Disability, Literacy
Different ACA Enrollment Rules Based on Medicaid-eligibility and Immigration Status
Risk of Coverage Gaps
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Gaps and Challenges for States: Consumer Experience
Source: Congressional Budget Office. “Recent Trends in the Variability of Individual Earnings and Household Income.” June 2008. http://www.cbo.gov/ftpdocs/95xx/doc9507/Frontmatter.1.2.shtml.
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Gaps and Challenges for States: Eligibility and Enrollment Policy
Streamlined Enrollment Policies New Coverage Paradigm
Major Eligibility Expansions Different Eligibility Rules for Medicaid vs. Exchanges
Separate Rules for MAGI/Non-MAGI Populations Need to Track Newly Eligibles for Increased FMAP State/Federal Eligibility Policies Conflict with ACA Intent
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Photo courtesy of Southern Institute on Children and Families
Gaps and Challenges for States: Technology and Infrastructure
Limited Online/Phone Enrollment Existing Eligibility Systems Often:
Outdated Disconnected Shared
Redundant
Technology Literacy Challenges Procurement, Legislative Oversight Speedy Implementation Timeframes Financing
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Gaps and Challenges for States: Governance and Administration
Political Leadership
Siloed Agency Work
Culture Change Imperative
Role of Local Agencies
Horizontal Integration of Human Service Programs
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Bridging the Gap
Helping States Reach 2014
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Bridging the Gap: Consumer Experience
Adopt Technologies to Support Consumer Connections
Enable Consumer Assistance and Engagement
Facilitate Coverage Transitions
Ensure Accessibility for Diverse Populations
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Bridging the Gap: Eligibility and Enrollment Policy
Simplify Processes and Policies
Minimize Data Collection; Increase Data-Sharing
Review and Address Policy Conflicts
Support Agency/Caseworker Culture Change
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Bridging the Gap: Technology and Infrastructure
Pursue New System Upgrades Through Federal Guidance
Evaluate Technology Needs and Available Resources
Pursue Economies of Scale
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Bridging the Gap: Governance and Administration
Identify State Priority Opportunities in Reform
Invest in Multi-Agency Collaboration
Develop Inventory of Local Functions to Inform Discussion of Future Local Roles
Choose Degree of Integration Between Health and Human Service Programs
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Conclusion
States at Crossroads: Major challenges, changes
needed
Opportunities for transformative change
State investment, leadership, planning critical
Federal support and oversight also essential
“Superhighway” within reach
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