Maryland HealthChoice Program: Should Maryland Move to a Selective Contracting Strategy? (2012)

Maryland Medicaid and the Maryland Children’s Health Program (MCHP) provide health care services to low-income individuals. Between them, the two programs cover over 950,000 individuals, approximately 80 percent of whom receive services through HealthChoice, a capitated managed care program. Beginning in January 2014, the Medicaid expansion that is included in the Affordable Care Act (ACA) is expected to add approximately 175,000 individuals to Medicaid, and these individuals will receive coverage from the Medicaid managed care organizations (MCOs).1 The newly created Health Care Exchange will provide coverage for an estimated 187,000 more adults in the subsidized individual market between 133 and 400 percent of the federal poverty level (FPL).2 Occasionally, certain parents will be covered in the Exchange at the same time their children will be insured by Medicaid or MCHP.