Feds Make It Easier For States To Enroll Poor Under Health Law
By Phil Galewitz
KHN Staff Writer
May 18, 2013 - Kaiser Health News
The Obama administration is making it easier for states to sign up the poor
for health coverage – and to help those people stay covered.
On Friday, it informed state officials that they could simplify enrollment in
Medicaid, the federal-state program for the poor, to handle the onslaught of
millions of anticipated enrollees next year when the health care law expands
coverage. The administration said the changes are geared to
states that are expanding their programs, but they may also be adopted by
others.
At least 22 states have committed to expanding Medicaid, one of the chief
ways the law extends coverage to the uninsured, and several more are
undecided, according to consultant Avalere Health. The Supreme Court made
expansion of Medicaid optional, and some Republican-controlled states have opted
against it.
In a letter to state officials, federal Medicaid Director
Cindy Mann laid out several ways states might streamline enrollment for adults,
including using data people have already submitted to qualify for foods stamps –
a practice that a few states permit for children.
States may also allow adults to stay enrolled in the program for up to a
year, even if their income changes, she said.
Allowing adults to stay in the program when their income changes is a gbig
deal,h said Alan Weil, executive director for the National Academy for State
Health Policy. He said it was likely to reduce the large number of people
churning in and out of the program, which interferes with their ability to get
care. Thirty-two states now use this option for children.
In states moving forward with the expansion, residents with incomes up to 138
percent of the federal poverty level -- or about $33,000 for a family of four --
will be eligible for coverage. About 13 million people are expected to enroll in
Medicaid starting next year, according to the Congressional Budget Office.
Mannfs letter outlines several options state can use to streamline enrollment
and retention. gEnrollment strategies that target individuals likely to be
eligible for Medicaid, and for whom eligibility information is already in the
statefs files, provide important advantages both for uninsured individuals and
for states,h she wrote.
To help states deal with the demands of increased enrollment, they will have
the option in the first three months of next year to extend the Medicaid renewal
period by up to 90 days. That means that if an individual on Medicaid comes
up for renewal on Feb. 1, their eligibility could be extended to May.
gThis is part of our longstanding ongoing effort to continue to simplify and
streamline enrollment and renewal in Medicaid, said Donna Cohen Ross, a senior
policy adviser at the Centers for Medicare & Medicaid
Services (CMS).
Cohen Ross said the administration is employing lessons learned from
enrolling children in Medicaid. Louisiana and South Carolina, for instance, have
used the food stamp strategy to help sign up thousands of children, but states
have not previously had the option for adults.
Similarly, CMS said states can use existing government data to sign up
parents whose children were already enrolled in Medicaid.
© 2013 Henry J. Kaiser Family Foundation. All rights
reserved.