1. Center on Budget and Policy Priorities cbpp.org Improving Benefit Access in States, ACA Opportunities and Challenges Working Families Success Network Conference Shelby Gonzales, Center on Budget and Policy Priorities November 7, 2013 0

2. Center on Budget and Policy Priorities cbpp.org ChildrenChildless Adults Working Parents Jobless Parents Pregnant Women 250% Subsidized Unsubsidized 37% 61% New Health Coverage Landscape in 2014 0% 185% Medicaid and CHIP coverage, based on 2012 eligibility levels in a typical state Source: Kaiser Commission on Medicaid and the Uninsured FPL 400% 100% 133% 200% 300% Current Medicaid / CHIP Eligibility Expansion Coverage Gap

3. Center on Budget and Policy Priorities cbpp.org 2 About Half the States Are Likely to Expand Medicaid in 2014 As of October 30, 2013

4. Center on Budget and Policy Priorities cbpp.org Source: Kaiser Family Foundation Vision for Streamlined Enrollment Dear ______, You are eligible for… Real-Time Eligibility Determinations Data Hub $ # Use of Electronic Data to Verify Eligibility Medicaid CHIP Exchange HEALTH INSURANCE Single Application for Multiple Health Programs Multiple Ways to Enroll

5. Center on Budget and Policy Priorities cbpp.org New Application Requirements Pose Opportunities and Challenges New standards that can provide key protections Multi-benefit applications must be approved A lot of new information is requested from consumers

6. Center on Budget and Policy Priorities cbpp.org Most SNAP Households Will Have Members Eligible For Medicaid Under Health Reform Note: This Figure considers SNAP households that contain at least one member who is not elderly or receiving SSI. The percentages shown here are the shares of those households in which the household members who aren’t elderly or on SSI will be financially-eligible for Medicaid under the ACA’s Medicaid expansion. Source: CBPP analysis of Census Bureau data.

7. Center on Budget and Policy Priorities cbpp.org States Have the Option to Administratively Enroll SNAP Participants in Medicaid States can apply for a waiver (an easy waiver that is processed quickly) to fast track eligibility for SNAP participants: – States identify SNAP applicants and participants that can be fast-tracked – Minimal additional work to complete the Medicaid eligibility process: Consumers consent to enroll Citizenship can be verified electronically

8. Center on Budget and Policy Priorities cbpp.org States Taking the Option Are Seeing Impressive Results 65,000 have consented to enroll in AR 45,500 have consented to enroll in IL 67,000 have consented to enroll in OR 52,000 have consented to enroll in WV

9. Center on Budget and Policy Priorities cbpp.org Connecting People to Health Benefits and More Buzz around health can be a mechanism to enroll families in other programs Systems can be designed to be integrated or interoperable to avoid duplication – look to 2015 Community based assistance can bridge systems that are siloed Consider setting and measuring expectations for coverage, e.g. 100% of poor children enrolled in SNAP and Medicaid.

10. Center on Budget and Policy Priorities cbpp.org CMS Guidance on Administrative Enrollment: CMS State Health Official Letter Facilitating Medicaid and CHIP Enrollment and Renewal in 2014 http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SHO-13-003.pdf http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SHO-13-003.pdf CBPP Paper on SNAP Administrative Enrollment: State Medicaid Agencies Can Now Easily and Efficiently Enroll Several Million SNAP Participants Who Are Eligible for Medicaid http://www.cbpp.org/files/SNAPMedicaidStreamline.pdfhttp://www.cbpp.org/files/SNAPMedicaidStreamline.pdf CBPP ACA Toolkit: Coordinating Human Services Programs with Health Reform Implementation: A Toolkit for State Agencies http://www.cbpp.org/files/6-6- 12health.pdfhttp://www.cbpp.org/files/6-6- 12health.pdf CBPP Website on ACA Policies: Beyond the Basics http://www.healthreformbeyondthebasics.org/ http://www.healthreformbeyondthebasics.org/ Resources