the exchange? I can do that, but who does that help? And my staff isn't just putting widget A into widget B. They are working with people who have Intellectual and Developmental Disabilities.
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I did include post-expansion Medicaid. This applies to our part time staff and back-up staff and those on the bubble. And as I said to start with, this isn't my model. It is the model under which I operate, as directed by CMS, DHHS, LMEs, and MCOs.
Medicaid and the ACA exchange are nowhere near the same thing. One is state administered and mostly federally funded. The exchange is private insurance, which may or may not be subsidized.
xamples: Of course if we offered non-ACA coverage, even the staff who would prefer to stay on the exchange lose that option. Now they are in a situation of, shitty insurance with lower pay over yonder, or higher pay with ACA eligibility here.
xamples: And we pay premium rates. In a state where our staff usually make an average of $13 per hour, we pay $17 per hour. Plus we pay the ACA penalty annually for them to use the exchange, which again, if we offered in house they would lose that option.
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