Journal
HEALTH AFFAIRS
Volume 34, Issue 7, Pages 1180-1187Publisher
PROJECT HOPE
DOI: 10.1377/hlthaff.2014.1204
Keywords
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Funding
- Commonwealth Fund [20100392]
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Medicaid churning-the constant exit and reentry of beneficiaries as their eligibility changes-has long been a problem for both Medicaid administrators and recipients. Churning will continue under the Affordable Care Act because, despite new federal rules, Medicaid eligibility will continue to be based on current monthly income. We developed a longitudinal simulation model to evaluate four policy options for modifying or extending Medicaid eligibility to reduce churning. The simulations suggest that two options-extending eligibility either to the end of a calendar year or for twelve months after enrollment-would be the most effective methods for reducing churning. The other options-a three-month extension or eligibility based on projected annual income-would reduce churning to a lesser extent. States should consider implementation of the option that best balances costs while improving access to coverage and, thereby, the health of Medicaid enrollees.
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