9 Million People Will Bounce Between Medicaid and Coverage This Year

This is going to cause a massive headache for the folks who have to navigate this system.  In many cases individuals will opt to not take a raise in pay to avoid losing their government handouts.   

This is from Churning between Medicaid and exchanges could leave gaps in coverage, experts warn - The Washington Post: 

The process — called “churning” — is common in Medicaid, the state-federal program for the poor and disabled. Typically, people lose Medicaid eligibility after their income spikes temporarily, such as when they get a seasonal job or pick up extra hours at certain times of the year. They re-enroll when their income drops.

Until now, people who churn out of Medicaid because of an income bump often wound up uninsured because they cannot afford private insurance. Starting this month under the Affordable Care Act, many will become eligible for insurance and subsidies through the exchanges.

[C]hurning will ... be a problem as patients bounce between Medicaid and the exchanges. Patients in an exchange plan may end up in a Medicaid managed-care plan run by another company, with different doctors, or vice versa. ...

9 million people will shift between Medicaid and the exchanges during the year. ...

All sides agree, however, that churning affects quality and interrupts care for Medicaid patients.

With Medicaid, people generally must reapply for or renew coverage every six or 12 months, depending on the state. They also must report changes in income or family composition, such as a marriage or divorce, which could affect eligibility. They could be dumped from the rolls any given month. ...

Experts say that whatever changes states make, they won’t be able to eliminate churning. ...