By Beth Morrow | October 2010
The success of the Affordable Care Act in achieving near-universal health coverage will depend on the effectiveness of the enrollment and renewal processes that states put in place. The law establishes the expectation that systems should enroll individuals with the minimum possible burden and handle transitions seamlessly.
This brief, published in partnership with the Kaiser Commission on Medicaid and the Uninsured, explains the key enrollment-related provisions of the health reform law, discusses the elements of an enrollment system that would comply with the law's requirements, and offers strategies -- and examples -- of how to achieve such a system.
With a quickly approaching 2014 deadline, states must begin working together with federal agencies and stakeholders to put critical policies and systems in place. As states address the immediate challenge of designing and building an Exchange, coordination with Medicaid and CHIP at all points in the enrollment process -- from application at the front-end, to data retrieval and verification at the back end -- is a fundamental organizing principle.
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This Framework lays out, step by step, how eligibility, enrollment, and retention should work for consumers so that California can meet the expectations of the Affordable Care Act. While developed for California, this Framework can be used in any state to help stakeholders focus on the elements that matter most for consumers. It is designed to be a practical resource for decision-makers as they work to achieve our shared goal: a simple, efficient door into health care in California that works well for its consumers.
