Building a Better Health Care Marketplace: Policy Briefing #6

The Exchange and Public Programs

CALPIRG Education Fund

EXECUTIVE SUMMARY

Medicaid will see its eligibility significantly increased in 2014, the same year the state exchange will open its doors. Many of those who apply for Medicaid will not be eligible for that program, but could qualify for tax credits to buy coverage on the exchange – and vice versa, as some of those who enter the exchange might also be eligible for a public program. Further, over time consumers might move from one to the other as their income fluctuates

States that carefully address these eligibility, enrollment, and transition challenges will save money due to increased efficiency, and consumers will have an easier experience getting their coverage. Those that do not run the risk of burying the promise of health reform in confusion and red tape.  Beyond these coverage issues, the state can also take action to integrate its public programs with the exchange to achieve greater effectiveness in both.