the affordable care act: a state implementation update
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The Affordable Care Act: A State Implementation Update. Rachel B. Morgan RN, BSN, Health Committee Director National Conference of State Legislatures 10 th National Forum For Heart Disease & Stroke Prevention October 17, 2012. Affordable Care Act Basics. Signed into law March 23, 2010 - PowerPoint PPT PresentationTRANSCRIPT
R a c h e l B . M o r g a n R N , B S N , H e a l t h C o m m i t t e e D i r e c t o r
N a t i o n a l C o n f e r e n c e o f S t a t e L e g i s l a t u r e s
1 0 t h N a t i o n a l F o r u m F o r H e a r t D i s e a s e & S t ro k e P re v e n t i o n
O c t o b e r 1 7 , 2 0 1 2
The Affordable Care Act: A State Implementation Update
Affordable Care Act Basics
Signed into law March 23, 2010
ACA coverage expansion
1. American Health Benefit Exchange
2. Medicaid expansion
3. Eligibility and enrollment simplification
4. Insurance market reforms
Requirements for prevention and wellness coverage in Medicare, Medicaid, and in the private insurance market
Supports improvements for delivery of health care services
American Health Benefit Exchanges
Requires that a health insurance exchange be established in every state by Jan. 1, 2014.
Health Insurance Exchange Options1. State-Based Exchange (SBE)-state performs all exchange
functions
2. Federally-Facilitated Exchange (FFE) Federal government performs all exchange functions State Partnership Exchange-states share administration of the
exchange and can be the primary entity plan administration or consumer assistance or both
Key Implementation Deadlines
Essential Benefits Package (EHB) Benchmark Plan Selection-Sept. 30, 2012 (soft deadline)
Health Insurance Exchange Blueprint-Nov. 16, 2012
Secretary certifies State readiness for State-Based Exchanges, or Federal Partnership Exchanges-Jan. 1. 2013
Open enrollment period begins-Oct. 2013 through March 2014
Exchanges become fully operational Jan. 1, 2014
Exchanges must be self sustaining by Jan. 1, 2015
States that have taken no action
States that have submitted a plan
(includes preliminary plans)
AL, FL, IA, IN, LA, MA, ME, MN, MS, NC, NJ, OH, OK, PA, SC, TN, TX, WI, and WV
AR, AZ, CA, CO, CT, DC, DE, DE, HI, IL, KS, KY, MA, MD, MI, ND, NE, NM, NV, NY, OR, RI, UT, VA, VT, and WA
EHB Benchmark Plans-Status
Jurisdictions with lawsStates with Executive
Orders
CA, CO, CT, DC, HI, MD, OR, VT
KY, NY, RI
State Exchange Update
States that have submitted letters regarding the “blueprint” for a SBE
States that have indicated they will not participate in any form of an exchange
CA, CO, CT, DC, HI, MA, MD, MN, OR, RI, NY, VT, WA
AK, FL, LA, ME, SC, SD, TX
State Exchange Update
The Medicaid Provisions in the ACA
Expands eligibility levels for nonelderly with incomes at or below 133% of the federal poverty level (FPL).
Streamlines the enrollment and eligibility process.
Consolidated eligibility categories into four groups-adults, children, parents, and pregnant women
Provides an enhanced federal match, 100%, for the newly eligible starting in fiscal year (FY) 2014-2016.
Requires state Medicaid systems to interface with a Federal Data Services Hub.
Effects of the U.S. Supreme Court Ruling on the Medicaid Expansion
Limited the ability of the federal government to withhold all federal Medicaid funding unless states accept and comply with the ACA Medicaid expansion requirements.
Only the funding for the Medicaid expansion may be withheld if as state declines to participate.
States that Plan to Expand their Medicaid Program
States that are Opting Out of the Expansion
CA, CT, IN, MA, MD, MN, MO, RI, VT, WA
FL, GA, LA, MS, SC, TX
State Decisions on the Medicaid Expansion
Key Prevention Provisions in the ACA
Required coverage of clinical preventive services in Medicare, Medicaid, and private insurance plans.
Establishes a framework for federal community-based prevention activities.
Establishes the “Prevention and Public Health Fund.”
Unfunded Provisions
CHIPRA Childhood Obesity Demonstration Project
Better Diabetes Care
Public Access Defibrillation Programs
National Diabetes Prevention Program
• November 6th!!!!
• If there is an Obama Administration the ACA proceeds as planned.
• If there is a Romney Administration ….????
RACHEL B. MORGAN RN, BSNHEALTH COMMITTEE DIRECTOR, NCSL
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