Explaining Health Reform: Eligibility and Enrollment Processes for Medicaid, CHIP, and Subsidies in the Exchanges

The new health reform law will require most U.S. citizens and legal residents to have health coverage by 2014. It provides new options for coverage by expanding Medicaid eligibility to more low-income people and creating a state-based system of health insurance exchanges through which individuals can purchase coverage, with federal subsidies for many.

Published in partnership with the Kaiser Commission on Medicaid and the Uninsured, this brief and accompanying explanatory chart summarize key requirements that states face under health reform to construct coordinated and consumer-friendly enrollment systems that help people understand their coverage options, and that use electronic data-matching and online processes to minimize the burdens of application and renewal, create a “no wrong door” system, ensure that people obtain the appropriate coverage, and support seamless transitions between Medicaid, CHIP, and subsidized coverage in the Exchanges.

States will need to begin planning and developing their policies, procedures, and systems right away to be prepared for 2014.

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