The Urban Institute has released a new issue brief with findings from RWJF's SHARE grantee Stan Dorn titled, "Reconciling House and Senate Health Reform Proposals: Eligibility, Enrollment, and Retention Policies that Will Maximize Health Coverage among the Low-Income Uninsured." The brief, featured in a recent Congressional Quarterly article, provides recommendations about how to reconcile the current Senate and House health reform bills in order to facilitate the effective identification, enrollment, and retention of individuals who become newly-eligible for Medicaid, CHIP, and exchange subsidies under federal reform.
In order to prevent people "falling through the cracks" as they try to negotiate their way among multiple programs, Mr. Dorn recommends that the final version health reform legislation:
- Require a single application form and a common eligibility system for Medicaid, CHIP and exchange subsidies;
- Apply the same streamlined eligibility and enrollment procedures to Medicaid and CHIP that are planned for the exchange;
- Base eligibility for all three programs on existing government data whenever possible;
- Apply 12-month eligibility periods to all programs, with exceptions for mid-year adjustments when necessary.
In making these recommendations, Mr. Dorn draws upon his SHARE-funded evaluation of Massachusetts' 2006 health reforms. This evaluation shows that key factors contributing to Massachusetts' success in covering 97.4% of its population included, among others, data-driven eligibility and the use of a single application form and eligibility system for all public programs.
While the next steps for national reform are unclear at this point, SHARE and SHADAC continue to work with states and researchers to provide research-based recommendations to reform our health care system and increase coverage and access to care.
Link to a PDF of Mr. Dorn's new issue brief from the Urban Institute.