Leveraging Opportunities in Health Care Reform

Nov 02, 2011

By Elizabeth Lower-Basch

Provisions in the health care reform law passed last year give human services agencies a major opportunity to modernize systems, reduce administrative costs and error rates, improve the customer experience, and expand coverage. These opportunities are outlined in a new paper, How Human Services Programs and Their Clients Can Benefit from National Health Reform Legislation, written by Stan Dorn, senior fellow at the Urban Institute. The paper is released by the Coalition for Access and Opportunity, of which CLASP is a co-convener.

The Patient Protection and Affordable Care Act (ACA) allows states to scale up and streamline enrollment in health insurance programs using enhanced federal funding for a limited time. Through Jan. 1, 2015, the federal government will pay 100 percent of the cost of developing health insurance exchanges, and through Dec. 31, 2015, the federal government will pay 90 percent of the cost of IT development for Medicaid eligibility systems. Human services programs can benefit from this opportunity because of recent guidance clarifying that the enhanced federal funding can pay for the full cost of necessary improvements to computer systems that are used by both Medicaid or the Exchanges and other programs. 

Streamlining benefits application processes is critical to successful implementation of health care reform given the dramatic extension of Medicaid eligibility to non-elderly adults and children with incomes up to 138 percent of the federal poverty level (FPL). The ACA also allows for refundable tax credits to subsidize the purchase of private health insurance for individuals in households with incomes at or below 400 percent of FPL.  Applicants will be able to apply for public benefits in a variety of ways, including online, by phone, mail, fax, or in person. Customers could even begin an application one way and finish another. Records will be checked in real time, while customers are waiting, so many will be able to receive an immediate approval.  Applications will be screened simultaneously for Medicaid, CHIP and the tax-based subsidies, regardless of where the customer makes the initial approach.

On Nov. 14, the Coalition for Access and Opportunity will host a webinar for state advocates and administrators to learn more about the remarkable opportunities for state health and human service integration under the Affordable Care Act. Stan Dorn will discuss this important new paper and Claudia Page, co-director of Social Interest Solutions, who is working with various states on these initiatives, will share her knowledge of promising steps and common challenges from around the country.

Advocates can learn more at CLASP's Benefit Access and Health Care Reform Resources page, and with the following additional resources:

The Health and Human Service Integration Opportunity Tool Kit

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