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Paving a Health Coverage Enrollment Superhighway
- 1. 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
- 2. 2 Overview ACA’s Vision: An Enrollment Superhighway State Gaps and Challenges in Streamlining Enrollment Bridging State Gaps to 2014 Conclusion
- 3. 3 ACA’s Vision: An Enrollment Superhighway
- 4. 4 ACA’s Enrollment Vision Transformation from: …To: Welfare-Era Modern Burdensome Easy to Use Seamless Disconnected Interconnected Complex Simple Paperwork-intensive Technology-Enabled
- 5. 5 Gaps and Challenges for States
- 6. Gaps and Challenges for States: 6 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
- 7. 7 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.
- 8. Gaps and Challenges for States: 8 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 Photo courtesy of Southern Institute on Children and Families
- 9. 9 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for States: Technology and Infrastructure Limited Online/Phone Enrollment Existing Eligibility Systems Often: Outdated Disconnected Shared Redundant Technology Literacy Challenges Procurement, Legislative Oversight Speedy Implementation Timeframes Financing
- 10. 10 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
- 11. 11 Bridging the Gap Helping States Reach 2014
- 12. Bridging the Gap: 12 Consumer Experience Adopt Technologies to Support Consumer Connections Enable Consumer Assistance and Engagement Facilitate Coverage Transitions Ensure Accessibility for Diverse Populations
- 13. Bridging the Gap: 13 Eligibility and Enrollment Policy Simplify Processes and Policies Minimize Data Collection; Increase Data- Sharing Review and Address Policy Conflicts Support Agency/Caseworker Culture Change
- 14. Bridging the Gap: 14 Technology and Infrastructure Pursue New System Upgrades Through Federal Guidance Evaluate Technology Needs and Available Resources Pursue Economies of Scale
- 15. Bridging the Gap: 15 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
- 16. 16 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