Commonwealth Fund: Strategies to Reduce Health Insurance Churn
Churning in health insurance enrollment has long been a problem for many people, as changes in their life circumstances create a cycle of losing and regaining eligibility for coverage. For millions of Americans, the Affordable Care Act means an end to the worst form of churning — the loss of insurance coverage entirely. But the law also introduces a new risk: individuals and families with changes in income may move back and forth between Medicaid and subsidized marketplace coverage. For individuals with chronic health issues, such as mental health and substance use disorders, coverage gaps inhibit care continuity.
A new Commonwealth Fund report identifies opportunities to reduce churn and its negative impact, including use of Medicaid dollars to subsidize the purchase of private plans through the marketplaces, and allowing adults and children to enroll in Medicaid or the Children’s Health Insurance Program continuously for 12 months. In addition, some state Medicaid agencies have experience developing policies to support smooth transitions between Medicaid managed care plans, and these policies (e.g., special considerations for patients in the midst of a course of treatment, inter-plan coordination, and health records transfer) can be applied to reduce the negative impacts of churn across health coverage options.