The following blog was written by Elisabeth Rodman, Healthy Policy Analyst at Families USA.
Under the health care law (the Affordable Care Act), enrolling in health coverage will become much easier, and it all starts with leaving your paper documentation at home. Beginning in 2014, people applying for subsidized health coverage will not need to provide physical proof of their citizenship, income, or other personal information, as long as that information can be obtained in other ways. Americans will no longer need to search for their birth certificates and pay stubs to apply for coverage, nor will they have to take time out of their workday to visit an eligibility office. Not only are these simplifications a requirement of the Affordable Care Act, but they were reaffirmed by the exchange and Medicaid proposed regulations issued by the Centers for Medicare and Medicaid Services. These proposed rules explain that there are databases that already collect most of the information needed to make an eligibility determination for Medicaid or exchange coverage, and the federal government will be creating an electronic service (sometimes referred to as the “federal data hub”), that will make data from a number of federal agencies available to states. State exchanges and Medicaid agencies will make use of existing information to simplify the application and enrollment process for consumers.
So how will this new system work? It might not look the same in every state, but by 2014, people applying for health coverage will be able to provide identifying information – such as their name, date of birth, and Social Security Number – on paper, online, or over the phone to apply for health coverage. Then, with the applicant’s permission, the eligibility system will “ping” existing electronic databases. In many cases, this simple step will get all the information needed to make an eligibility determination for the exchange (including eligibility for premium tax credits and cost sharing reductions), Medicaid, CHIP, or Basic Health (where applicable). States cannot require people to provide paper verification for any information that can be obtained through these databases.
The same process can be used to make renewing coverage paperless, as well. States must use existing data to confirm an individual’s ongoing eligibility and to renew coverage. Enrollees would be given an opportunity to update any information used to process their renewal, but otherwise, if data suggest they are still eligible, they will continue to be enrolled without having to deal with paperwork, in-person meetings, or other renewal hassles.
By harnessing the power of technology, the new health coverage enrollment and renewal process will be completely revamped; it will be simpler, faster, and more consumer-friendly. It will also be data-driven, which can help improve program integrity (see The Secrets of Massachusetts’ Success: Why 97 Percent of State Residents Have Health Coverage). Going “paperless” is just one of the ways a modernized enrollment process will make it easier to get—and keep—health coverage.]]>