PRESS RELEASE: Experts Offer Insight on Aligning Medicaid, Health Insurance Exchanges and the Individual Market

WASHINGTON, DC – A new report offering states valuable insight on how to coordinate Medicaid and health insurance Exchange markets – an option that could increase the efficiency and effectiveness of the Affordable Care Act (ACA) – was released today by the National Academy of Social Insurance (NASI). The ACA, which authorized the creation of Exchanges, also calls for a Medicaid expansion that will bring an estimated 16 million newly eligible enrollees into the program by 2019, according to independent budget experts.

“The ACA and regulations released since its passage focus in part on aligning Medicaid and Exchange policies so that individuals and families experience seamless coverage,” said Sara Rosenbaum, co-author of the report with Trish Riley, both of the George Washington University School of Public Health and Health Services. “Because so many of the newly eligible will switch between Medicaid eligibility and receiving tax subsidies through Exchanges, it is essential that the two work together to ensure continuity of coverage so individuals and families don’t fall through the cracks.”

Building a Relationship between Medicaid, the Exchange and the Individual Insurance Market addresses key areas where states can focus their efforts to promote continuity of coverage, including: establishing a joint strategy to align health plan policies across markets, aligning the eligibility determination and redetermination process, and coordinating benefit design across multiple markets.

The new report, part of a NASI project funded by the Robert Wood Johnson Foundation (RWJF), is intended to help guides states through the web of federal regulations, rules and guidance to identify areas for Medicaid/Exchange collaboration. The report also considers issues not included in regulations and offers recommendations on how states can achieve policy objectives, such as incentivizing cross-market participation. Related products include a toolkit offering legislative language for policymakers implementing Exchanges and issue briefs on Exchange governance, active purchasing and federally-facilitated Exchanges.

Webinar: Please join NASI and RWJF for a webinar on January 10, 2012 featuring Rosenbaum and Riley, as well as Deborah Bachrach and Patricia Boozang, authors of a report released in December 2011 on the continuum of federal and state options in establishing Exchanges. Click here to RSVP.

Contact Information: For more information about Building a Relationship between Medicaid, the Exchange and the Individual Insurance Market, contact Sara Rosenbaum at Sara.Rosenbaum@gwumc.edu or Trish Riley at Trish@Riley.net. For information about NASI’s Health Insurance Exchange project, please contact Lee Goldberg at lgoldberg@nasi.org or visit www.nasi.org.