Lessons from New York: Building a Better Medicaid Eligibility and Enrollment System for Duals
Medicare Rights Center
Expanding Health Care Coverage
September 10, 2012
This NYSHealth report, developed by the Medicare Rights Center, examines various options for states to ensure that the gains in Medicaid access and eligibility coverage benefit all Medicaid-eligible populations.
The report examines efforts in New York State and Federal options to avoid a two-tiered system, offers recommendations, and makes the case for replicating these measures in other states.
Under the Affordable Care Act (ACA), Medicaid eligibility is set to be expanded to new populations and the Federal government provides significant funding for states to build new eligibility and enrollment systems that would be quicker and less onerous than current application processes. However, the ACA did not explicitly require states to extend such improvements to all Medicaid populations, such as those with disabilities or over the age of 65. As a result, states would be left expending significant funds on operating two separate Medicaid eligibility systems. Further, some of the most vulnerable Medicaid populations—burdened by poverty, illness, and age—would be relegated to antiquated enrollment systems and a different set of rules.