Meg Murray, Founding CEO of the Association for Community Affiliated Plans (ACAP)
Please tell us about ACAP, your mission, and what you do?
ACAP, or the Association for Community Affiliated Plans, is a coalition of 79 not-for-profit Safety Net Health Plans across the nation. Together, these plans serve more than 25 million individuals through various public health programs, such as Medicaid, Medicare, CHIP, the Marketplace, and others.
Safety Net Health Plans are deeply ingrained in the communities they serve, prioritizing individuals who have limited financial resources. This commitment underscores our dedication to equitable healthcare coverage and access. Our overarching goal is to fortify the capabilities of our not-for-profit Safety Net Health Plans, enabling them to enhance the health outcomes and well-being of individuals with low incomes or significant health challenges.
Could you tell us about your career journey and what got you involved in ACAP as it was getting started?
I think you can go back to my childhood: I remember my father telling me about his experiences growing up in an uninsured family, where his mother battled illness. This caused significant family instability as a result. His stories seeded my interest in healthcare – but it really took off when I started my career with a position in the Massachusetts State House, where I worked on revenue policy and witnessed firsthand the impact of Medicaid on state budgets.
I pursued graduate studies at Princeton, and I interned essentially down the street at the Robert Wood Johnson Foundation, focusing on state health policy. This, in turn, led me to Washington, where I worked on Medicaid waivers at OMB, and later served as Medicaid director in New Jersey as they integrated the SSI population into managed care.
In thinking about my next move after leaving New Jersey, a mutual friend connected me with Chris Koller, who was the chair of a new association – the Association for Health Center-Affiliated Health Plans, which initially representing 17 plans affiliated with CHCs. That was the start of a terrific partnership committed to improving Medicaid managed care. Since then, we’ve streamlined our name, expanded our mission and grown to more than 79 member plans, now known as safety net health plans.
What do you see as the biggest challenge for the ACAP member plans over the next 3-5 years?
Let’s see—off the top of my head, there’s prescription carve-outs; the rise of artificial intelligence across a host of functions, not the least of which is prior authorization; state reprocurements; mergers and acquisitions, and the constant background of a challenging environment for Federal and state budgets – which, to be sure, has been a challenge especially for Medicaid since the program’s founding; we’re always trying to do more with less.
The good news, I suppose, is that for people who love tackling a challenge, there’s no shortage in the Medicaid managed care space!
What is one key goal you want to achieve at ACAP in 2024.
ACAP’s Safety Net Health Plans work in all lines of business – Marketplaces, Medicaid and CHIP, and Medicare – so when I think about our goals, I like to think of them in ‘threes’!
In the Marketplaces, we just celebrated the busiest and most successful open enrollment season ever. We know this is in part due to advanced premium tax credits which ensure that no consumer pays more than 8.5% of their income on health insurance. We firmly believe that health insurance should be both comprehensive and affordable, which is why we’re advocating for this to continue beyond 2025, as well as looking forward to the Administration’s final rule ensuring short-term, limited-duration insurance plans can no longer masquerade as an alternative health insurance option.
On the Medicaid side, we’re thrilled that last year, 12-month continuous eligibility was enacted for children nationwide. Now, we’re looking to see this protection expanded to adults through the Stabilize Medicaid and CHIP Coverage Act.
In Medicare, we’re advocating for H.R. 6742, the IDEAL Act. This bill champions social determinant of health supplemental benefits and integrated care for dually eligible beneficiaries. Representative Blumenauer of Oregon introduced this last December, and we’re now looking for co-sponsors in the House and an introduction in the Senate.
Our member plans were just on the Hill last week advocating for these legislative asks and we’re truly looking forward to seeing what’s to come later this year.
