Medicaid managed care ready for new enrollees, states say


Many Republican-led states have refused the invitation, saying fuller Medicaid rolls will balloon their budgets.

The eight states surveyed — Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island and Virginia — are all expected to expand their Medicaid programs. The projected increases in enrollment range from 23 percent (New York) to 102 percent (Oregon) by 2022.

The study cited a variety of factors that will ease these states' transition into a fuller Medicaid program. These included "stable and mature" managed care structures, long-standing relationships with qualified health plans, and familiarity with the populations that will be newly covered under healthcare reform.

"New Mexico has gained experience with providing coverage to low-income adults through its State Coverage Insurance program, and New York already providers Medicaid to adults in the expansion eligibility range through Family Health Plus," study authors wrote.

"Considering this previous experience, state officials and health plans alike feel that they have a good sense of what to expect with the ACA expansion group," they added.

One "predominant" concern related to the operability of states' information technology systems in a post-expansion environment.

These systems must provide a seamless eligibility determination and enrollment process, encompassing both Medicaid and soon-to-launch insurance exchanges.

"State officials have devoted much of their time over the last two years to establishing a system that is ACA-compliant," the study stated. "Even so, state officials are acutely aware that they are undertaking a significant change for which a new IT system is still being developed, and doing all of this under tight deadlines."