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Expanding Coverage Under the Affordable Care Act

The Expanding Coverage MAC Collaborative is helping states to translate the Medicaid eligibility and enrollment standards and processes required by the Affordable Care Act into program design options and create implementation tools. Specific topics may include:

  • Considerations for interface agreements between exchanges and Medicaid with respect to eligibility and enrollment processes;
  • Required and optional data elements for the model single application;
  • State discretion in establishing verification processes, including application of the reasonable compatibility standard;
  • Benefit benchmark design options and considerations; and/or
  • Impacts of the newly-mandated Medicaid coverage expansion on pre-existing state coverage initiatives (such as the breast and cervical cancer programs and family planning waivers).

Potential work products of the learning collaborative, designed to support state implementation, may include model MOUs, draft standards and policies and model process or work flows.

The Expanding Coverage MAC Collaborative began in January 2012 and will run through September 2012 or later.

Participating States

  • California
  • Minnesota
  • New Mexico
  • New York
  • Oregon
  • Tennessee
  • Washington
  • West Virginia

Facilitators and Subject Matter Experts

Lead Facilitators

  • Deborah Bachrach, Special Counsel, Manatt Health Solutions
  • Melinda Dutton, Partner, Manatt Health Solutions

Lead Subject Matter Experts

  • Anne Marie Costello, Acting Director Division of Eligibility, Enrollment & Outreach, Children and Adults Health Programs Group, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
  • Brenda Sheppard, Policy, Division of Eligibility, Enrollment & Outreach, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services