Assessment and Synthesis of Selected Medicaid Eligibility, Enrollment, and Renewal Processes and Systems in Six States

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November 2018

The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) made significant changes to Medicaid enrollment and renewal processes, with the goal of making the program more efficient; reducing complexity and effort for enrollees and program administrators; and integrating Medicaid with the health insurance exchanges.

To better understand how states implemented these changes affecting beneficiaries whose income eligibility is determined based on modified adjusted gross income (MAGI), MACPAC contracted with the State Health Access Data Assistance Center at the University of Minnesota to examine eligibility, enrollment, and renewal practices in six states. This report summarizes how MAGI-Medicaid populations apply to and are determined eligible for the Medicaid program, and describes these states’ approaches to streamlining enrollment and renewal for these populations, common themes among the states, and states’ future plans to further streamline enrollment and renewal.

If you are looking for a shorter read, you can find our issue brief summarizing the case study findings on eligibility, enrollment, and renewal here. To read each state’s case study, visit the links below.


Publication Type: Contractor Reports

Contractor Reports

Tags: administration, Affordable Care Act, eligibility, eligibility determination, enrollment, exchanges, renewal of eligibility