With each day that passes, we get closer to the Oct. 1, 2013 inaugural open enrollment for the Health Insurance Marketplaces (formerly health insurance exchanges).
Fewer than 200 days (including weekends and holidays) remain. You would think as each day passes more answers than questions would appear and yet, for every answer, it appears 3 new questions arise.
For example, there is a great deal of dialogue around state decisions regarding Medicaid expansion at this time. This is a politically charged decision that has had some surprising twists and turns.
However the key to this decision point is that the decision itself of ‘which state will’ and ‘which state won’t expand’ leads to new questions on how to provide coverage for those who fall into the gaps?
Currently 14 states have decided to not expand Medicaid coverage to newly eligible individuals between 100 and 138% of the federal poverty level with another 9 states undecided or leaning against.
See the current status of expansion choices at the following link from The Advisory Board Company.
What/Where is the net that will catch these low income individuals who fall into the gaps and what is the best strategy for determining who they are and where will they obtain affordable coverage? Predictably, there is no one size fits all answer and the possible responses to these questions are being debated as these words are being typed out.
This type of decision will no doubt put additional strains on systems and processes that are already struggling with the defined areas of MAGI Medicaid eligibility and enrollment.