Enrollment of Individuals Transitioning frm Medicaid or CHIP to marketplace coverage

Enrollment of Individuals Transitioning frm Medicaid or CHIP to marketplace coverage

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, MD 21244-1850 CMCS Informational Bulletin DATE: September 29, 2016 FROM: Vikki Wachino Director, Center for Medicaid and CHIP Services SUBJECT: Enhancing Enrollment of Individuals Transitioning from Medicaid or CHIP to Marketplace Coverage Since the passage of the Affordable Care Act (ACA), states have made substantial progress in enrolling and retaining eligible individuals in Medicaid and the Children’s Health Insurance Program (CHIP). A key aspect of continuing this progress is making sure that individuals who have either lost Medicaid or CHIP coverage or were determined ineligible upon application are able to transition to other sources of coverage and financial assistance, if applicable, as seamlessly as possible. Over the past three years of operation of the Federally-Facilitated Marketplace (FFM), we have learned through data analysis that there is more potential to enroll in Marketplace coverage individuals who are determined not or no longer eligible for Medicaid or CHIP and who have been transferred to the FFM via account transfer. This potential can be realized through a number of enhancements to the account transfer process. This CMCS Informational Bulletin (CIB) highlights the ways states served by the FFM can help to facilitate enrollment in Marketplace coverage for people transferred to the FFM when denied Medicaid/CHIP eligibility by the state Medicaid/CHIP agency. This CIB also provides information that may be useful for State-based Marketplaces working to improve their eligibility and enrollment coordination processes with state Medicaid/CHIP agencies. In addition, this CIB highlights ways states can make enhancements to the application and collection of data to help with successful enrollment. First, individuals are more likely to seek enrollment through the Marketplace if they have sufficient information to understand what will happen once the state has transferred their account to the Marketplace. Providing additional information to individuals found ineligible for Medicaid/CHIP regarding the transfer of their application from the state to the Marketplace will help to facilitate seamless coverage transitions. Second, enhancing the types of outreach, including the use of email outreach, to this population is essential to increasing the percentage of individuals who enroll in Marketplace coverage after being found ineligible for Medicaid or CHIP. Again, while this CIB focuses on transfers to the FFM, these improvements may be relevant to some State-based Marketplaces as well Adequate information and targeted outreach efforts are especially important for young adults – a group with historically high rates of uninsurance. When children become young adults, many lose eligibility for Medicaid or CHIP, or drop off of their parents’ coverage. Consistent with this, prior to the implementation of the Marketplaces and other ACA coverage provisions in 2014, 19 year-olds were nearly 8 percentage points more likely to be uninsured than 18 year-olds. Recent
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