Issue Brief | Nov 11, 2011

Medicaid Managed Care: How States’ Experience Can Inform Exchange Qualified Health Plan Standards

Manatt Health Solutions – Deborah Bachrach, Patricia Boozang and Allison Garcimonde

State Affordable Insurance Exchanges (exchanges) are at the core of the coverage reform in the Affordable Care Act (ACA). The exchanges establish a marketplace in which individuals and small employers can compare and select among affordable, quality health insurance options. In this policy brief, supported by the State Network and published by the Center for Health Care Strategies, authors from Manatt Health Solutions examine lessons from Medicaid managed care contracts in six states. The brief notes opportunities for exchanges to “borrow” from and align qualified health plan standards with Medicaid managed care requirements, as well as areas where managed care requirements may need to be modified for adoption in exchanges.