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Medicaid Expansion: Critical Decision Point. Brian Osberg Center for Best Practices National Governors Association. About NGA. Federal Relations/Advocacy Center for Best Practices; Non-Profit. Medicaid Expansion: State Option. Part of Federal Health Reform Law Near “universal coverage”

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medicaid expansion critical decision point

Medicaid Expansion:Critical Decision Point

Brian Osberg

Center for Best Practices

National Governors Association

about nga
About NGA
  • Federal Relations/Advocacy
  • Center for Best Practices; Non-Profit
medicaid expansion state option
Medicaid Expansion:State Option
  • Part of Federal Health Reform Law
  • Near “universal coverage”
  • Surprising Supreme Court Decision
  • Economic, Financial and Political Factors
covered population
Covered Population
  • Adults under 65 with income under 138% of Federal Poverty Level (FPL)
  • Approximately half of the uninsured
  • Mostly adults without dependent children
  • Partial Expansion Not Permitted
covered population1
Covered Population
  • Potential Growth of 21.3 Million by 2022
  • Continued Restrictions for Non-Citizens
  • Streamlined Eligibility Determination
  • Coordinated with Insurance Exchange
  • Increased Outreach and Application Assistance
  • Spectrum of Coverage
what is covered
What is Covered?
  • Must cover 10 “essential health benefits”
  • Includes Mental Health and Substance Abuse
  • Known as “Alternative Benefit Plans”
  • Exemptions for “Medically Frail” Continue
  • Limited Cost Sharing; No Premiums
medicaid management
Medicaid Management
  • Trend Towards Managed Care Continues
  • New Models of Delivery/Payment
    • Health Homes; Behavioral Health Homes
    • Medicaid Accountable Care Organizations
    • Bundled Payment
    • Intensive Care Management for ‘Super-Utilizers’
    • Integration of Mental and Physical Health
health management challenges
Health Management Challenges
  • Unmet Medical Needs
  • Multiple Social Service Issues
  • Multiple Chronic Conditions
  • Requires Innovative Approach
    • Camden Model
    • Hennepin Health
expansion status
Expansion Status
  • http://www.statereforum.org/medicaid-expansion-decisions
  • Let’s Make A Deal
  • Decision Can Be Reversed
  • Too Early to Tell
thank you
Thank You
  • Brian Osberg,

Acting Director, Health Division

Center for Best Practices

National Governors Association

bosberg@nga.org