Meet the Board: Meg Murray of the Association for Community Affiliated Plans Talks ACA, Race and Equity and More

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Meg Murray, M.P.A.

Below is a brief Q&A of the interview with Murray, which has been edited for clarity purposes.

Q: Can you tell our listeners and readers briefly about your career in healthcare and how it started?

A: My interest in healthcare started when I was fairly young. In my family, my father used to always talk about how his mother was sick when he was young, how family didn't have health insurance and the impact that had on their family. So that was kind of how my interest started in the importance of health insurance. In terms of my career, I started my career after college in state government. I worked in the House Ways and Means Committee, and although I worked on revenue issues at the time, the issues in those year - it was when Dukakis was running for for President 1987 88. In that time frame. Like today, the state governments budgets were being driven by Medicaid. And so I became very interested in Medicaid because of my interest in state government. Eventually, I made my way to the federal level. And I worked worked on the Medicaid managed care waivers, the 1115 process for OMB, And so that's really kind of had been was my path to healthcare.

Q: tell us a little bit more about how the Association for community affiliated plans got started and what your role was? And why isn't Association like this needed?

A: We actually got started in the year 2000. So we just had our 20th anniversary, which, like so many others, we were not able to celebrate during COVID, we had planned on having a big celebration. But the organization got started in 2000 by a group of 14 Community Health Center affiliated plans with some funding from hersa. And they had come together because they were like minded plans across the country. And they had incorporated before I came on board, but I was the first executive director, because they all have day jobs and weren't able to move the association that much further. So that was that was the start 14 plans. And now we're up to 78 plans, we've expanded over time to not be an association of just CHC affiliated plans, but all nonprofit plans that are focused on Medicaid.

Q: Let's pause and discuss the Dirty Dozen - a little bit of Medicaid expansion. The expansion of Medicaid in 12 states may or may not have takers. What are your thoughts on how to complete Medicaid expansion, which after all, when the ACA was written before the court decision, it was supposed to be done on a national basis. What are your thoughts on on expanding into those 12 states?

A: We were certainly supportive of the change in the law that would have given them actually, I think it's 90% for all their other Medicaid lives in addition to the expansion. It's an incredible bargain for state so we are certainly supportive of that provision. We don't lobby at the state level, so, we don't get involved in that. However, we, at the national level, were supportive of it then. They say there's 2.2 million people that might get coverage if those 30 haven't taken it up. That's extremely important, but there's 10 million people that are currently eligible in the other states and don't have Medicaid yet.

That's why we have been pushing for the 12 month continuous eligibility again, to keep people on and we're also very interested in the ideas behind auto enrollment. I'm actually on an advisory board in Maryland, which Maryland is experimenting with asking people on the tax forms: Do you have health insurance? Or do you want information on health insurance? Using the information on the tax forms, they can reach out to people in the marketplace to see if they want to enroll or put that they're on Medicaid by looking at the income levels so they can get them enrolled in Medicaid.

So and that has been pretty successful in Maryland. So far in terms of just you educating more people about the marketplace. Certainly, there's a lot of chitter chatter now about whether that could be done at the federal level. So I think that we need to focus as much on the people that are already eligible but not enrolled. There's a lot more of them than there are an expansion states. But clearly we need to get the Dirty Dozen to support the people in their states and get them health insurance.