Beginning in October, 2013, states initiated their first open enrollment period for health coverage under the ACA. While state approaches varied, all states implemented new rules, system interfaces, and data reporting methods required under the ACA. What are states learning so far about what works to enroll eligible individuals and what are their top-line priorities getting ready for the next open enrollment period in November 2014? This webinar provides an opportunity to learn about promising strategies and innovations states are piloting related to enrollment and retention into insurance affordability programs, including through state-based exchanges and coordination with the federally facilitated marketplace (FFM). State panelists from Kentucky, Montana and Washington share experiences and enrollment successes. NASHP also shares new findings from research with 10 states documenting promising strategies, common challenges and trends in state enrollment experience as part of the Enrollment 2014 project.
- Anne Gauthier, Director, State Health Exchange Leadership Network, National Academy for State Health Policy (Moderator)
- Alice Weiss, Director, Enrollment 2014 Project, National Academy for State Health Policy
- Carrie Banahan, Executive Director, Office of Kentucky Health Benefit Exchange (Kynect)
- Christina Goe, General Counsel, Montana Commissioner of Insurance
- Nathan Johnson, Division Director, Health Care Policy, Washington Health Care Authority
The Affordable Care Act includes pediatric dental services as one of ten essential health benefits that state and federal health insurance marketplaces must offer. However, dental is treated differently from other essential health benefits, creating unique implementation challenges. With support from the DentaQuest Foundation, NASHP held an expert meeting with state and federal marketplace officials, dental stakeholders, and national experts to identify major issues in delivering dental benefits through marketplaces, concerns with implementation to date, and potential policy and program solutions that can be implemented in future years. This report presents findings related to pediatric and adult dental coverage, benefit design, affordability, and plan selection.
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Various types of assisters are at work across the country to support consumers with enrollment in health coverage. Consumers will be screened for eligibility for both Medicaid and the marketplace and will be referred to the appropriate program for enrollment, regardless of where they first seek coverage. State Medicaid agencies can play an important role to help ensure marketplace assisters are trained on the essentials of the Medicaid program. Medicaid agencies are also offering information on the marketplace to their staff. This brief provides an overview of federal training for marketplace assisters as well as examples of how state Medicaid agencies in Federally Facilitated Marketplace (FFM) and State Partnership Marketplace (SPM) states have worked with a diverse set of partners to advise on, develop and deliver state-specific consumer assistance training.
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Individuals and families began to explore options and enroll in coverage through the Affordable Care Act (ACA) on October 1, 2013. States now have nine weeks of experience with open enrollment under their belts and can share early lessons learned in what worked and what did not, and managing the rough spots. During this Maximizing Enrollment and State Refor(u)m-sponsored webinar, a NASHP expert will describe some of the early experiences shared by state officials at the 2013 NASHP Annual State Health Policy Conference and other NASHP convenings held in October. Officials from states with different marketplace and Medicaid models will reflect on open enrollment in their states so far, highlighting their successes and challenges to date, their experiences with outreach and messaging, and how their operations and systems are performing. Panelists will describe their approaches in these key areas and identify priority areas for states as they look to January 1, 2014 when health insurance coverage under ACA takes effect.
- Moderator: Catherine Hess, Co-Director, Maximizing Enrollment; Managing Director for Coverage and Access, National Academy for State Health Policy
- Speaker: Joanne Jee, Program Director, National Academy for State Health Policy
- Speaker: Michael Koetting, Deputy Director for Planning and Reform Implementation, Illinois Department of Healthcare and Family Services
- Speaker: Richard Onizuka, Chief Executive Officer, Washington Health Benefit Exchange
- Speaker: John Supra, Deputy Director for Information Management and Chief Information Officer, South Carolina’s Department of Health and Human Services
|Click to download presentation slides (PDF)||7 MB|
States with Partnership or Federally Facilitated Marketplaces (FFM) are coordinating closely with the federal government on Medicaid eligibility and enrollment. Each state Medicaid agency has chosen whether the Marketplace will only assess, or whether it will also determine Medicaid eligibility for individuals who apply through the Marketplace. This brief outlines the responsibilities of the FFM in assessing or determining Medicaid eligibility, explains the differences between these two models and examines the rationales behind two states’ choices. This brief was made possible through the support of the Robert Wood Johnson Foundation.
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Tess Shiras joined NASHP in 2013. As a Research Assistant for the Health System Performance team, Tess works primarily on projects related to healthcare payment and delivery system reform. Prior to joining NASHP, she was an intern at Partners In Health, an organization that works globally to provide affordable health services to those living in extreme poverty. She has also interned in Jodhpur, India working for a women’s empowerment organization where she helped plan and facilitate a health education training for female community members. As an undergraduate, Tess completed her honors thesis work on prenatal care access among low-income women in North Carolina. Tess graduated from Duke University in 2013 with a BA in Public Policy, concentrating in Health Policy, and Global Health.
States are currently mobilizing their efforts to provide assistance to individuals who will be able to enroll in coverage through the health insurance exchanges beginning in October. All exchanges will offer some level of enrollment assistance through Navigator, or in some case, In-Person Assistance (IPA) programs, as well as support provided by certified application counselors, exchange call centers and websites, and agents and brokers. This State Refor(u)m webinar will highlight the key features of consumer assistance strategies being employed by exchanges. State panelists from two state-based exchanges and a state partnership marketplace will also address the varying ways that they are coordinating these efforts in their states and some of the implementation issues they anticipate facing when open enrollment begins this fall.
- What is your state’s overall vision or approach to consumer assistance?
- What is the scope and format of training offered for Navigators and in-person assisters?
- How is your state exchange planning to handle consumer assistance hand-offs between call centers, Navigators and IPA programs and state Medicaid agencies?
- How does your state plan to monitor and evaluate the effectiveness of consumer assistance provided?
Heather Howard, Director, State Health Reform Assistance Network
Rachel Dolan, Policy Specialist, National Academy for State Health Policy
Anita Cardwell, Policy Specialist, National Academy for State Health Policy
Sandra Cook, Consumer Assistance Specialist, Arkansas Health Connector
Adela Flores-Brennan, Network Assistance Manager, Connect for Health Colorado
David Van Sant, Navigator and Broker Manager, MNsure
|Download the Presentation Slides (PDF)||5.2 MB|
Since 2009, eight states participating in the Robert Wood Johnson Foundation’s Maximizing Enrollment program have worked to streamline eligibility and enrollment systems for children and those eligible for coverage in 2014. These states’ use of technology to support application and renewal simplifications, customer interfaces, system functioning, and workflow management have paved the way for many ACA provisions. This Maximizing Enrollment report—the first in a series of final reports from the program—shares findings and lessons learned from the state grantees’ experiences of adopting and piloting inventive technology strategies that may inform other states’ implementation of ACA and future eligibility and enrollment improvements.
Co-Author: Katie Baudouin, Policy Specialist
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