The Affordable Care Act (ACA) creates two new subsidies in an attempt to insure 32 million people: expanded Medicaid eligibility and subsidized insurance sold in a health insurance exchange. Yet there’s a fire wall between the two. If you are eligible for Medicaid, you can’t be in the exchange and vice versa. A new study in Health Affairs suggests than an administrative nightmare is just around the corner:
The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, we estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty level will experience a shift in eligibility from Medicaid to an insurance exchange, or the reverse; within a year, 50 percent, or 28 million, will.