Repealing Eligibility and Enrollment Modernization—What Would it Mean for States?

Prepared for the Robert Wood Johnson Foundation State Health Reform Assistance Network

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

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  • 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  • How likely is it that modified adjusted gross income (MAGI) would be repealed?
  • What would it mean for states if MAGI rules are repealed?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?