GAO releases Medicaid expansion report
Posted on August 1, 2012 | No Comments
The Government Accountability Office (GAO) recently released a report on Medicaid expansion under the Affordable Care Act (ACA). The report does not take into account the June 28th United States Supreme Court decision.
Congress asked the GAO to report on the actions states are taking to implement the Medicaid expansion. This report addresses the following questions:
1. What are states’ responsibilities for implementing the Medicaid expansion provisions under ACA?
2. What actions have selected states taken to prepare for the Medicaid expansion provisions of ACA and what challenges have they encountered?
3. What are states’ views on the fiscal implications of the Medicaid expansion on state budget planning?
The six selected states included in the GAO study (Colorado, Georgia, Iowa, Minnesota, New York, and Virginia) are taking some steps to prepare for the Medicaid expansion, including assessing changes that need to be made to their existing eligibility levels and eligibility determination policies. In an effort to streamline their eligibility and enrollment processes, the six states also are taking steps to upgrade or replace their Medicaid information technology systems and have submitted applications to CMS for enhanced federal funding for this purpose. In interviews, officials noted that the enhanced funding provides the states with an opportunity to update outdated eligibility and enrollment systems. At the same time, state officials reported challenges to implementing ACA’s Medicaid expansion requirements, including the need for additional federal regulations and guidance in a number of areas.
In terms of states’ views on the fiscal implications of the Medicaid expansion on states’ budget planning, the survey found that across fiscal years 2012 to 2020, the majority of state budget directors believe that three aspects of Medicaid expansion will contribute to costs: (1) the administration for managing Medicaid enrollment, (2) the acquisition or modification of information technology systems to support Medicaid, and (3) enrolling previously eligible but not enrolled individuals in Medicaid.
- Implementing the early adoption of Modified Adjusted Gross Income (MAGI)-based rules;
- Extending the Medicaid renewal period so renewals that would otherwise occur during the first quarter of calendar year 2014 will occur later;
- Enrolling individuals into Medicaid based upon Supplemental Nutrition Assistance Program (SNAP) eligibility;
- Enrolling parents into Medicaid based upon children's income eligibility; and
- Adopting 12-month continued eligibility for parents and other adults.