Forty-nine states have begun the activity necessary to have health insurance exchanges operational by 2014.
For those individuals and families between 133% and 400% of federal poverty level (FPL) who purchase individual market insurance products through the health benefit exchanges, federal subsidies will be available. In many states, certain populations above 133% of FPL are eligible currently for Medicaid. Now these states will need to decide the break point between Medicaid and exchange-subsidized insurance.
MILLIONS EXPECTED TO CHURN
If these individuals take part-time or other work with no benefits, and their income rises above the Medicaid threshold, they shift from Medicaid to the exchange to buy federally subsidized policies. A recent study by Harvard and George Washington University showed that as many as 28 million individuals could be expected to churn among these programs in the first year exchanges are operational.
Exchanges must be designed as part of the continuum of insurance within the state. States are considering several options:
Over the next two years, as states design exchanges and revisit their Medicaid programs, the challenges of churn are certain to be front and center in any discussion on program design.
This column is written for informational purposes only and should not be construed as legal advice.
Cindy Gillespie is managing director for McKenna Long & Aldridge LLP.
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen
Price Transparency Reveals Multiple Dimensions of Healthcare Inequities Beyond Just Patients
October 23rd 2024Pricing data shows that doctors serving these communities facing economic challenges are paid less by insurers, effectively penalizing doctors for working in areas where people most need their care.
Read More
In our latest "Meet the Board" podcast episode, Managed Healthcare Executive Editors caught up with editorial advisory board member, Eric Hunter, CEO of CareOregon, to discuss a number of topics, one including the merger that never closed with SCAN Health Plan due to local opposition from Oregonians.
Listen