New york has some of the best benefits for a medicaid patient but still had 50% of potential patients are not enrolling..My job at a large medical center was to assist patients in the enrollment process however waiting for the patient to respond was not working..I have now tripled my community medicaid enrollments by committing resources and working very closely with the state but i had to first sell this concept internally..the question asked of me....why should we spend money on this project when the state is supposed to be doing this and it reduces charity?..my answer was it was good for the patient and provider(did need to show ROI)and we could not wait for the government ..

The government can not enroll people in free health insurance. Perhaps HHS should do what all of the commercial health insurance companies do: pay a commission to licensed agents to enroll people. Problem solved.

Coverageforall.org has done a fantastic job identifying all of the government programs available for health insurance in addition to commercial coverage. What they have found is that nobody answers the phone at Medicare offices. By and large, most enrollment in Medicare and SCHIP is done by providers at the point someone needs coverage - this is to ensure the provider gets paid. Licensed agents reach out to people when they are healthy and get them enrolled - which is much better for the system. Licensed agents also cost nothing until they actually enroll someone - unlike a big government agency that has huge fixed costs- regardless of their success. We need to think outside of the box and trust the private sector to do something that is is clearly capable of doing.

Presumptive eligibility, can really only be about presuming financial information is correct (taking family's statement of household income)...Medicaid cannot presume the demographic eligibility, and therefore verification of citizenship, age, and such is still required. I am not certain hospitals are pressured to write kids' accounts off to charity, rather than help them get on public programs (Medi-Cal), each process is considered community benefit.

However, there should be a tighter relationship among physician offices, hospitals, and other agencies in order to be more proactive in providing outreach and education to families. As opposed to waiting for them to seek health services.

If states really want to increase enrollment they should allow providers the right to enroll under presumptive eligibility..This would expedite patients into a primary care system which improves their health outcomes.However there are forces that are creating disincentives to make this happen.
1)pressure on hospitals to write off accounts as charity care(IRS AND PUBLIC SCRUTINY) and not invest in the enrollment process(in particular community medicaid)..
2)states have no incentive to increase enrollment..the reason providers need to have more power in the process ..