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Comparing Medicaid and Exchanges: Benefits and Costs for Individuals and Families


This report provides broad comparisons between federal statutorily required beneficiary benefits and costs associated with Medicaid and the exchanges. The analysis is focused on the beneficiary's perspective, and does not address costs to the federal government or the states associated with the ACA expansion provisions. The analysis of the potential implications on populations less than 65 years of age is divided into four groups: (1) non-disabled children, (2) pregnant women, (3) non-disabled adults, and (4) individuals with chronic disabling conditions (i.e., individuals whose chronic condition leads to a disability). Medicaid's different statutory eligibility classifications determine the benefits that the individual is entitled to as well as cost sharing obligations they must meet. This report does not include an analysis of the impacts on Medicaid's age 65+ populations (those populations who are dually eligible for Medicare and Medicaid), as these individuals, by virtue of their eligibility for Medicare, are not permitted to receive federal subsidies through the exchanges. This report does not attempt to capture statespecific details on program design, but rather provides a comparison of the federal requirements that will structure the choices available to states in designing their programs. This analysis is by no means exhaustive; rather it is illustrative of the complexities that are inherent in the interactions between Medicaid and the exchanges.9 While the analysis is current, the overall coverage and regulatory landscape is evolving. This report reflects information about how the Administration will likely implement certain aspects of the coverage provisions of the ACA based on regulations and other administrative guidance and announcements that were publicly available at the time of the publication of this report. For a discussion of the fundamental differences between Medicaid and ACA exchanges that shape the interactions between these programs


THE DOCUMENT INCLUDES FOLLOWING FILES:
# FILE NAME Document Date Order ID: Number of Pages PRICE
1 R42978.pdf Feb 28, 2013 R42978 26 $29.95 ADD TO CART

Older Versions:

Comparing Medicaid and Exchanges: Benefits and Costs for Individuals and Families  [Order No: R42978  Release Date: Feb 28,2013  Pages: 26]