Medicaid's Transformation: Implications for National Health Policy

The Affordable Care Act sets national minimum standards and rules for public and private insurance but affords states considerable flexibility in implementing them. The Supreme Court decision that made Medicaid expansion optional increases that flexibility and ensures there will be substantial variation across states in the proportions of residents who are insured and underinsured. Sara Rosenbaum will draw upon her four decades of expertise in Medicaid to inform federal and state policymakers about the early effects of the expansion and how differences in state approaches might lead to disparities in the extent and quality of coverage. Rosenbaum and her team will monitor and assess the following: 1) eligibility and enrollment for current and expanded state Medicaid programs; 2) use of alternative expansion approaches; 3) decisions regarding scope of benefits; and 4) state efforts to coordinate Medicaid with private plans sold through the marketplaces.