Manatt on Health: Medicaid Edition

How Would Repealing Eligibility and Enrollment Provisions Impact States?

By Patricia Boozang, Senior Managing Director | Kinda Serafi, Counsel | Jocelyn Guyer, Managing Director

While the focus of debate regarding repeal of the Affordable Care Act (ACA) has been on Marketplaces and the Medicaid expansion, a myriad of other provisions of the ACA are at risk of repeal—including those that streamline Medicaid eligibility and enrollment systems and implement a national, simplified standard for income eligibility. The House of Representative’s recently released repeal legislation, the American Health Care Act, does not eliminate any of the ACA’s eligibility and enrollment simplifications. However, the repeal reconciliation bill, H.R. 3762, passed by Congress and vetoed by President Obama in 2016 would have eliminated many of these provisions.

In a new issue brief for the Robert Wood Johnson Foundation State Health Reform Assistance Network, Manatt Health addresses key questions for states regarding the future of the ACA’s streamlined eligibility and enrollment-related provisions and the system improvements states have invested in to implement them.

  • What Medicaid eligibility and enrollment simplification provisions are at risk of repeal?
  • Are repeal proposals likely to eliminate the ACA eligibility and enrollment streamlining requirements?
  • How likely is it that Modified Adjusted Gross Income (MAGI) would be repealed?
  • What would it mean for states if MAGI rules are repealed?
  • What are the unique ACA repeal considerations for Medicaid eligibility and enrollment operations in states that have state based marketplaces?
  • What are the unique ACA repeal considerations for Medicaid eligibility and enrollment operations in states that rely on the federally-facilitated marketplaces (FFM) eligibility and enrollment platform (FFM, state-based marketplace-federal platform state)?
  • Will states be able to continue to access 90/10 matching funds for modifications or upgrades to their Medicaid eligibility and enrollment systems?

Click here to read the full issue brief, including the answers to the key questions for states.

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