Coordinating Medicaid and the Exchange in New York

The Affordable Care Act (ACA) envisions access to affordable care for all Americans, a streamlined eligibility and enrollment process to obtain coverage, and seamless integration between Medicaid and the Exchange to ensure smooth transitions between sources of coverage as a person’s circumstances change over time. This paper explores the issues associated with these coordination challenges and identifies options for New York as it considers how to best approach the integration of coverage options along the continuum from fully subsidized public coverage to partially subsidized and unsubsidized private coverage offered in the Exchange.