title: Reducing Medicaid Churning: Extending Eligibility For Twelve Months Or To End Of Calendar Year Is Most Effective.
abstract: Medicaid churning--the constant exit and reentry of beneficiaries as their eligibility changes--has long been a problem for both Medicaid administrators and recipients. Churning will continue under the Affordable Care Act because, despite new federal rules, Medicaid eligibility will continue to be based on current monthly income. We developed a longitudinal simulation model to evaluate four policy options for modifying or extending Medicaid eligibility to reduce churning. The simulations suggest that two options--extending eligibility either to the end of a calendar year or for twelve months after enrollment--would be the most effective methods for reducing churning. The other options--a three-month extension or eligibility based on projected annual income--would reduce churning to a lesser extent. States should consider implementation of the option that best balances costs while improving access to coverage and, thereby, the health of Medicaid enrollees.
authors.affiliation: Katherine Swartz (kswartz@hsph.harvard.edu) is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health, in Boston, Massachusetts.
authors.forename: Katherine
authors.initials: K
authors.lastname: Swartz
authors.affiliation: Pamela Farley Short is a professor in the Department of Health Policy and Administration at Pennsylvania State University, in University Park.
authors.forename: Pamela Farley
authors.initials: PF
authors.lastname: Short
authors.affiliation: Deborah Roempke Graefe is a research associate at the Population Research Institute at Pennsylvania State University.
authors.forename: Deborah Roempke
authors.initials: DR
authors.lastname: Graefe
authors.affiliation: Namrata Uberoi is an analyst in health care financing at the Congressional Research Service, in Washington, D.C.
authors.forename: Namrata
authors.initials: N
authors.lastname: Uberoi
mesh_terms: D004608:Eligibility Determination / Q000458:organization & administration*; D007182:Income; D019458:Insurance Coverage / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D015233:Models, Statistical; D013997:Time Factors; D014481:United States
keywords: Health Reform; Medicaid