For health reform legislation to maximize coverage among low-income, uninsured Americans, the administrative details for subsidies need to make enrollment and retention simple, seamless, and as automatic as possible for consumers. Neither the House nor the Senate health reform bill extends to Medicaid the streamlined procedures that apply to other subsidies. And with multiple subsidy systems operating under reform, consumers could easily fail to receive coverage for which they qualify. To avoid such difficulties, lawmakers could establish, for all subsidy systems, a single, streamlined system for eligibility determination, enrollment, and retention that minimizes the need for consumers to complete paperwork.
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