Medicaid Benchmark Benefits under the Affordable Care Act: Options for New York   

Feb 8, 2013

This report, prepared by Health Management Associates, examines four options for New York’s Medicaid benchmark plan selection.  Under the Affordable Care Act (ACA), states are permitted to define the benefits package for a newly mandatory category of non-elderly, non-disabled adults.  In New York, most of these adults are already eligible for public coverage – including 1.1 million adults enrolled in Medicaid or Family Health Plus.  The four benefit options analyzed in this report are: 1)  Medicaid 2) Family Health Plus, 3) multiple benchmark plans and 4) commercial insurance.  As discussed in the report, under either of the first two options, all groups would have benefits equal or better than existing coverage, while the last two options would result in an erosion of benefits for some groups.  Finally, HMA discusses that providing a single benefit for all Medicaid beneficiaries has the advantage of administrative simplicity, which is consistent with broader goals of the ACA.

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