Should States Integrate Health Insurance Exchanges and Medicaid?

Under the Affordable Care Act of 2010 (ACA), an estimated 32 million Americans will gain health insurance coverage by 2014.

Many of them will gain insurance through an expanded Medicaid program. However, individuals and small businesses will have greater access to affordable health insurance through newly created health insurance exchanges.

  The ACA requires these state-based exchanges to create one integrated process that determines consumer eligibility for the full range of subsidies (including Medicaid) and to facilitate enrollment across the spectrum.

As states set out to design exchanges and determine how they will function, the question becomes: Once a person is deemed eligible for Medicaid, is he or she best enrolled through the exchange or through a separate Medicaid enrollment system?

This Health Policy Snapshot, published online in January 2012, examines how the benefits of an integrated system to consumers and what states face in implementation.

Read more from RWJF's Health Policy Snapshot series.

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