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dates establishment of health insurance exchanges — now referred to as mar- ketplaces — in every state as a way for individuals to purchase private health in- surance on their own and find out if they qualify for federal subsidies. If someone applies through the federal marketplace but appears to be eligible for Medicaid or the Children’s Health Insurance Pro- gram (CHIP), the marketplace will send the person’s information to the state. That’s where the Texas Health and
Human Services Commission (HHSC) suggests there could be delays and com- plications. The marketplace began using a new federal application and income eligibility rules Oct. 1. Texas Medicaid won’t implement the standards until Jan. 1, 2014, due in large part to federal de- lays in finalizing the exchange rules and launch date, as well as the time needed to make the necessary technology chang- es at the state level to prepare. HHSC officials are concerned the first
three months of the transition could be “especially complex” when determining if someone qualifies for Medicaid or CHIP. “We will go ahead and process the in-
formation we get from the marketplace to see if [those applicants] qualify under our current rules so they can get ben- efits as soon as possible,” said Stephanie Muth, deputy executive director of HH- SC’s Office of Social Services. Because of the gap between federal and state pro- cesses, however, “the information will need to be processed differently from October through December.” Ms. Muth said her office was working
to make sure eligibility staff statewide were as prepared as possible for the mar- ketplace opening on Oct. 1, adding that there would be “extensive training” until Jan. 1, 2014. The Texas Medical Association’s “Hey
Doc” educational campaign helps answer questions that you and your patients may have about the new health insur- ance marketplace. For more information, visit
www.texmed.org/heydoc/. n
Amy Lynn Sorrel is an associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
www.texmed.org/texmed2014 46 TEXAS MEDICINE November 2013
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