Eligibility Issues in Medicaid and CHIP: Interactions with the ACA

In Chapter 2 of its March 2013 report, MACPAC examines new eligibility determination requirements under the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) for Medicaid, the State Children’s Health Insurance Program (CHIP) and exchange coverage, including the Medicaid expansion to childless adults in some states, the requirement to streamline eligibility determinations and to standardize income-counting methodologies across states and programs, and the effect of these changes on churning.

Chapter 2 offers recommendations to Congress that, if enacted, would improve enrollment stability and better align a current Medicaid program known as Transitional Medical Assistance (TMA) with new provisions enacted by the ACA. Read more about how new eligibility processes affect Medicaid and CHIP as states and the federal government implement the ACA.