Medicaid’s Unique Role in the Healthcare System

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Importance of Medicaid

With the changing political climate, one aspect of the Affordable Care Act (ACA) that is being discussed is how any modifications to the federal law may impact Medicaid programs. Currently, Medicaid provides health care for approximately 70 million people nationally. Medicaid has always been a federal/state partnership in terms of funding and authority with participation being optional. All 50 states do participate though.

And while Medicaid benefits vary among the states, they all must meet initial federal minimum requirements. Over the years many states have expanded their options beyond the guidelines. The ACA took measures a step further by expanding eligibility to adults with incomes at or below 138% percent of the poverty line. Experts agree this filled a gap in the long-standing program and estimate that approximately a quarter of Medicaid’s insureds are a result of this expansion effort.

The next two efforts that the ACA impacted can help insurers’ future efforts in enrolling and reaching potential customers. The ACA helped modernize the enrollment process for Medicaid participants by requiring that states offer individuals multiple methods for applying such as online, by phone or mail. It also allowed for a centralized way for applicants to apply for coverage in some instances from the Marketplace and be enrolled in the correct coverage based on their eligibility. Creating a simplified, streamlined approach to enrollment creates an easy first customer experience for individuals that insurers can build upon to maintain excellence in customer service.

The ACA also acknowledged that new outreach efforts were needed to help people connect with the right coverage and to assist them during the process. Insurance is a complicated topic and health plans will do well to enhance their literacy programs and increase their local efforts to help people understand their options and feel good about their selection.

So in addition to expanding funding for Medicaid, the ACA provided additional contributions to the advancement of reaching and enrolling individuals in the health care system. The National Conference of State Legislatures continues to monitor federal discussions pertaining to the repealing or revising of the ACA and the states’ Medicaid considerations as well, here. The months ahead may provide more clarity for Medicaid’s unique role within the health industry.

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