Some states are taking different approaches to minimize churning between Medicaid and the health insurance exchanges, meaning insurers must take different steps depending on the marketplaces in which they participate.
About 9 million people will likely fluctuate between Medicaid and the exchanges this year. That switching could prove costly for both insurers and states, while consumers could end up with coverage gaps or forced to switch health plans or providers, reported The Washington Post.
"This is a critical issue for the states and the providers," said Jenna Stento, a senior manager who tracks the health law at consulting firm Avalere Health. "It could be a very significant population that is moving back and forth."
Jeff Myers, president of Medicaid Health Plans of America, told the Post churning could create a "serious" disruption to insurers' stability; plus, insurers won't be able to predict their financial risk. "The challenge is how the states want to address the churning issue," he added.
Some states already have taken steps to reduce churning. Nevada, for example, will require Medicaid insurers to offer a comparable plan available on the exchange this year. In Washington, officials are helping insurers selling exchange plans to also become Medicaid plans, if they offer an identical network. And insurers in Delaware must continue to cover approved medical treatment and medications during a transition period for new members who previously had Medicaid coverage, the Post noted.
Meanwhile, other consumers are waiting in limbo to obtain Medicaid coverage thanks to a lingering HealthCare.gov glitch that has kept more than 100,000 people determined eligible for Medicaid or the Children's Health Program unenrolled. This latest website snafu resulted from back-end technical problems with HealthCare.gov. Specifically, software flaws prevent transfer of applications from federal to state sites when individuals qualify for Medicaid or CHIP based on reported income levels, FierceHealthPayer previously reported.
To learn more:
- read The Washington Post article