The Supreme Court's ruling that states can opt out of the federal health reform law's Medicaid expansion adds complexity to the creation of state health insurance exchanges under the reform law, Government Technology reports.
Patrick Howard -- leader of Deloitte Consulting's public-sector state health care practice -- said the ruling could make writing the code and business rules for health insurance exchanges more difficult.
Initially, the back-end code required to implement the Modified Adjusted Gross Income formula, which determines Medicaid eligibility, in the health insurance exchanges was relatively straightforward, according to Howard. However, because some states have announced plans to opt out of the Medicaid expansion, the eligibility formula, as well as the computer programming required for the exchanges, have become more complicated, he said.
Jan Ruff -- senior vice president of business development for MAXIMUS Health Services -- said, "The biggest issue is they have to come up with a new way of calculating eligibility, and that has a technology implication."
Howard said that states should decide quickly whether they plan to participate in the Medicaid expansion in order to ensure that health insurance exchanges are successful.
Meanwhile, Bruce Caswell -- president and general manager of MAXIMUS Health Services -- said states should take inventory of existing resources that they can use to build the exchanges, including technology infrastructure (Heaton/Williams, Government Technology, 7/10).