Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges.

The Affordable Care Act will extend health insurance coverage by both expanding Medicaid eligibility and offering premium subsidies for the purchase of private health insurance through state health insurance exchanges. But by definition, eligibility for these programs is sensitive to income and can...

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Publicado en:Health Affairs Vol. 30; no. 2; pp. 228 - 237
Autores principales: Sommers, Benjamin D., Rosenbaum, Sara
Formato: Journal Article
Publicado: Health Affairs Publishing, LLC Feb2011
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges.
      aug:
        au:
          Sommers, Benjamin D.
          Rosenbaum, Sara
        affil: Harvard School of Public Health, Boston, Massachusetts
      sug:
        subj:
          Medically Uninsured
          Eligibility Determination Standards
          Health Care Reform Legislation and Jurisprudence
          Medicaid
          Insurance, Health Economics
          United States
          Human
          Income
          Time Factors
          Family Characteristics
          Poverty Standards
          Continuity of Patient Care
          Transitional Programs
          Certification Methods
          Prospective Studies United States
          Census United States
          Descriptive Statistics
          Adult
          Middle Age
          Probability
          Confidence Intervals
          Cox Proportional Hazards Model
          Adult: 19-44 years
          Middle Aged: 45-64 years
      ab: The Affordable Care Act will extend health insurance coverage by both expanding Medicaid eligibility and offering premium subsidies for the purchase of private health insurance through state health insurance exchanges. But by definition, eligibility for these programs is sensitive to income and can change over time with fluctuating income and changes in family composition. The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, we estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty level will experience a shift in eligibility from Medicaid to an insurance exchange, or the reverse; within a year, 50 percent, or 28 million, will. To minimize the effect on continuity and quality of care, states and the federal government should adopt strategies to reduce the frequency of coverage transitions and to mitigate the disruptions caused by those transitions. Options include establishing a minimum guaranteed eligibility period and "dually certifying" some plans to serve both Medicaid and exchange enrollees.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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