Briefs & Reports

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

New York State Department of Health

Denise Soffel, PhD
Robert Buchanan
Tom Dehner
David Fosdick
Lisa S. Maiuro, PhD

The New York State Department of Health enlisted Health Management Associates (HMA) to analyze available options for selecting a Medicaid benchmark benefit for people eligible for Medicaid’s new mandated adult category established by the Affordable Care Act (ACA).

This analysis reviews the revisions to Medicaid eligibility established by the ACA as it affects populations already covered under New York’s Medicaid and Family Health Plus programs, as well as those currently ineligible for public coverage. HMA colleagues identify and describe the options for a Medicaid benchmark benefit as defined by the ACA. The report also reviews the current Medicaid benefit package against the Essential Health Benefit standard and compares it with each of the Medicaid benchmark options.

The report concludes by discussing the implications of selecting a Medicaid benchmark in terms of the impact on currently covered groups and the comprehensiveness of the scope of benefits offered.