Commonwealth brief explores ACA challenges of keeping coverage after employment changes

The Commonwealth Fund has released a new policy brief that outlines the policy challenges of maintaining coverage under the ACA in instances where individuals have income and employment changes.

“The Affordable Care Act builds on existing sources of public and private health insurance, while creating new health insurance exchanges and subsidies. A potential disadvantage of preserving many sources of health insurance is the likelihood of abrupt changes in coverage or financial responsibility when individual circumstances change," according to the brief, titled "Maintaining Coverage, Affordability, and Shared Responsibility When Income and Employment Change."

This brief describes four policy challenges related to such changes: adjusting premium and cost-shar¬ing subsidies when incomes change; coordinating eligibility for premium credits, Medicaid, and the Children’s Health Insurance Program; encouraging and facilitating continuous coverage; and minimizing transitions between individual and small-business exchanges.