The Patient Protection and Affordable Care Act (ACA) expands Medicaid to cover all low-income individuals up to 133% FPL. State Medicaid agencies are charged with creating benchmark benefit packages for the 16-20 million projected new enrollees while coordinating eligibility and enrollment with the exchanges that will cover millions of Americans above 133% FPL. This meeting brought together a small group of experts to consider the issues around: 1) defining the benefit packages for the Medicaid expansion population; 2) the impact of benefit design on rates, risk adjustment and actuarial soundness; and. 3) how Medicaid benefits should be aligned with other subsidized insurance offerings in the exchange to minimize the impact on enrollees churning between the two programs.
For a brief overview of the meeting, visit the National Academy for State Health Policy's Refor(u)m blog (see Attending to Benefit Design post, 12/10/10).
I. Setting the Stage - Aligning Benefits Across Medicaid and the Exchange
Allison Hamblin, MSPH - Director, Complex Populations, Center for Health Care Strategies
Anticipating the Health Needs of the Expansion Population
Julia Paradise - Associate Director, Kaiser Commission on Medicaid and the Uninsured
Explaining Health Reform: Benefits and Cost-Sharing for Adult Medicaid Beneficiaries
II. Essential Health Benefits and Benchmarks
Darin Gordon - Medicaid Director, Tennessee
John Kaelin - Senior Vice President, Health Reform, United Healthcare
III. Coordinating Expansion and Exchange Delivery Systems
Andy Allison, PhD - Director, Kansas Health Policy Authority
John Bertko, FSA, MAAA - Senior Fellow, LMI Center for Health Reform