12/22/2023 0 Comments Mass health connector![]() These processes must be coordinated across Medicaid and the Benefits Exchange to create a “no wrong door” enrollment system. All states must also implement streamlined Medicaid enrollment processes that offer individuals multiple ways to apply (online, by phone, in person, by mail), rely on electronic data to verify information and attempt to provide real time eligibility determinations. States are allowed to run their own exchanges, use the federal exchange or build an exchange in partnership with the federal government. This private insurance is federally subsidized via premium tax credits for those with incomes between 100 % and 138 % of the federal poverty level (depending on whether states expanded Medicaid) and 400 % of the federal poverty level. ![]() This expansion is occurring by extending Medicaid coverage (comprehensive government insurance for low income individuals) to additional low-income residents in the 28 states that have agreed to a Medicaid expansion and by offering private health insurance plans to consumers through state Health Benefits Exchanges. Under the Affordable Care Act (ACA), non-elderly American adults began accessing new health insurance options in October 2013. The extent to which the ACA will ultimately be able to reduce barriers to accessing care will depend critically on the experiences of Americans in obtaining, keeping and using new insurance provided under the ACA. In addition, in order to have these new insurances pay for needed medical services, recipients must be able to understand and be able to effectively utilize these insurances. The new forms of insurance provided under the ACA, however, must be applied for through newly created health exchanges and kept active by periodically providing proof of continued eligibility. ![]() The ACA is a nationwide policy intervention designed to expand access to medical care through the largest increase in insurance to low income people in US history once fully implemented it is expected to cover 30 million of the approximately 50 million American that were uninsured prior to this reform. In order to address deep inequalities in access to care and health, the US implemented the landmark Patient Protection and Affordable Care Act (ACA) in 2014. Financial barriers to care, particularly for low income and uninsured people and racial and ethnic minorities, have been considerably higher in the US than in other wealthy nations. The United States has been anomalous among developed countries in lacking a system of universal healthcare coverage. Under the Affordable Care Act, efforts to simplify the application process and reduce the complexity of plans may be warranted, particularly for vulnerable patient populations cared for by the medical safety net. We found that although most patients with Medicaid or publicly subsidized exchange-based plans were able to obtain assistance with applying for and choosing an insurance plan, substantial proportions of respondents experienced difficulties with the application process and with understanding coverage and cost features of plans. We surveyed a convenience sample of 780 patients seeking care in a safety-net system who obtained Medicaid or publicly subsidized insurance after the Massachusetts reform, as well as a group of employed patients with private insurance. The Affordable Care Act was modeled on the Massachusetts Health Reform of 2006, which reduced the number of uninsured largely through a Medicaid expansion and the provision of publicly subsidized insurance obtained through a Health Benefits Exchange.
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