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Healthcare Reform

Insights on the ACA: Marketplace and Medicaid Reporting Requirements

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Note: ACA Watch is an ongoing, bi-weekly series with aggregated stories and insights on the latest developments regarding the Affordable Care Act. Look out for it every other Thursday.

With the debut of Health Insurance Marketplaces this month, Americans are starting to use these new online markets to shop for and purchase affordable insurance coverage. As these Marketplaces begin operating at full capacity, federal and state policymakers as well as other health reform stakeholders can now focus on evaluating the progress that is being made towards the Affordable Care Act’s (ACA) goal of expanding public and private insurance coverage to the nation’s uninsured and under-insured.

Implementation

NAMD Publishes Fourth Week of ACA Snapshot

The National Association of Medicaid Directors (NAMD) released the fourth snapshot in a series capturing the status of ACA implementation from the state perspective. The fourth week was marked by the re-opening of the federal government and increased communications between states and CMS; increased efforts to provide accurate and timely data; and new questions regarding the impact of procedural changes in account transfers on Medicaid agencies. This qualitative report is a summary of NAMD’s conversation with a representative sample of states.

State Watch

Mississippi Medicaid Director Could Seek Managed Care Expansion

Mississippi’s Medicaid Director wants to expand a managed care program that he says has helped save the state about $40 million. Medicaid Executive Director David Dzielak said 22 percent of Medicaid recipients are in managed care, in which a company is paid a set fee to provide medical services  regardless of the services’ actual cost.

Industry Watch

Measuring the Outcomes of Health Reform

The Centers for Medicaid and Medicare Services (CMS), in close collaboration and consultation with the states, has recently finalized a number of data collection and reporting requirements for tracking an individual’s progress in enrolling in affordable health coverage. These include creating an account, applying for affordable coverage options, and shopping, selecting, and enrolling in a plan that meets the consumer’s preferences. CMS notes that these requirements are focused on both (1) establishing accurate and timely data for monitoring and reporting purposes, and (2) tracking and evaluating the effectiveness of Marketplace and Medicaid/CHIP eligibility and enrollment processes.

Medicaid Enrollment Surges Ahead of ACA Sign-Ups

New Medicaid enrollment is far outpacing new insurance customers under the ACA so far, a subtle sign that the program could play a greater role in the law’s coverage expansion than first anticipated. Some people are signing up for the Medicaid expansion created by the president’s health law. Others were already eligible for their state’s current Medicaid program, but had never signed up until this health coverage outreach campaign. There are several reasons for the spurt of Medicaid coverage.