1. Building on a Strong Foundation of Coverage 2015 Annual Child Health Policy Conference Georgetown Center for Children and Families

2. Sweating the Hard Stuff Account Transfers, Renewals, and Churn Speakers: Anne Marie Costello Acting Director, Children and Adults Health Programs Group, Center for Medicaid and CHIP Services Jennifer Beeson Director, Consumer Support Group, Center for Consumer Information and Insurance Oversight Shelby Gonzales Senior Policy Analyst, The Center on Budget and Policy Priorities 2

3. Streamlined, seamless, coordinated coverage across the all insurance affordability programs No wrong door access Data-driven, real-time eligibility determinations Highly-automated renewal processes The Blueprint 3

4. Building the Systems More challenging than anticipated Initial focus: -MAGI conversion -Single streamlined application -Four modes of application 90/10 funding extension critical 4

5. How are we doing now? How is CMS helping states do better? 5

6. Account Transfers MedicaidMarketplace 6

7. Medicaid sends inbound transfer to FFM Account Transfer Process FFM populates application FFM sends notice to applicant to create or login to account PTC /CSR eligibility determined in “real time” and notice sent Eligible applicants able to enroll in plan INBOUND Medicaid to FFM FFM sends outbound transfer to Medicaid Medicaid populates application Medicaid reviews eligibility Medicaid sends notice or requests information Determined eligible or denied OUTBOUND FFM to Medicaid “Assessment” FFM sends outbound transfer to Medicaid Enrollment OUTBOUND FFM to Medicaid “Determination” Policy Option! 7

8. Account setup or login Medicaid backlogs Paperless verification Data inconsistencies Eliminating Bottlenecks 8

9. Paving the Way for Prompt, Gapless Coverage Medicaid Side Coverage effective date of application or renewal update Extending coverage to end of the month 12 month continuous eligibility Predictable income fluctuations Presumptive eligibility SNAP Marketplace Side Expedited inconsistency resolution SEP with accelerated enrollment 9

10. Marketplace Renewals What’s new for 2016? FFM Creates 2016 Application and Sends Notice Consumer takes no action Renewed in same or similar plan Eligible applicants able to enroll in marketplace plan Consumer updates information Eligibility re- determined in “real time” and notice sent Medicaid eligible account transfer 10

11. Medicaid and CHIP Renewals Electronic Verification Data confirms eligibility Notice of eligibility Report changesNo signature or return Data does not confirm eligibility Pre- populated form Provide info online, over phone, in person, via mail Verification Eligibility Determination Notice 30 day to provide proof 90 day reconsideration without new application Ex Parte 11

12. Delayed system development Access and linking to data sources Importing information from old legacy systems Challenges to Ex Parte State Successes The Evergreen State Washington The Ocean State Rhode Island > 60% Individuals Renewed Ex Parte > 90% Retention Rate 12

13. An Expedited Path to Renewal (and New Enrollment) 13 Using SNAP to Verify Eligibility

14. Addressing Churn What are we doing and else can we do? 14

15. Enhancing Consumer Assistance 3-Year Navigator Grants Boosted Funding for 2016 Assister Tools and Resources Training and Technical Assistance 15

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