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Health Reform Implementation
Updated March 2013

Overview

The federal Affordable Care Act (ACA) is legally designated  H.R. 3590, the Patient Protection and Affordable Care Act (PPACA, P.L. 111-148), and H.R. 4872, the Health Care and Education Reconciliation Act of 2010 (HCERA, P.L. 111-152). 

On June 28, 2012 the U.S. Supreme Court upheld most provisions of the Patient Protection and Affordable Care Act, but ruled that states could decine or accept the portion of the law that would expand eligibility requirements for Medicaid to to 133 percent for most adults. The 2010 enacted law called for cutting off all Medicaid funding to states that did not go along with the expanded eligibility provision. NCSL will continue to update and analyze the law and its effects on states. 
> See followup information at U.S. Supreme Court and the Federal Health Law.

The federal health law aims to expand coverage to 32 million more Americans. It relies on a combination of health insurance reforms, exchanges in all 50 states, Medicaid expansions, subsidies, tax credits and mandates. The law also allocates money to improve quality and halts certain widely criticized insurance practices. The biggest changes come in January 2014 when Medicaid expands and states create exchanges or marketplaces for health insurance. But first there’s much to do this year.

The federal changes provide a list of competitive grants and funding to help states set up health benefit exchanges, consumer assistance offices, review insurers’ rate hikes, support home nurse visits to high-risk pregnant women, and provide sex education and abstinence programs, among other things. Plus, the federal law directly allocates $11 billion to support community health centers.

NCSL RESOURCES: NCSL has a wide array of online material describing the new law and options for state and federal implementation. These include fact sheets, timetables, analyses of specific provisions, federal guidance and regulations, state responses, and growing lists of state legislative and state executive order and actions. 

These materials are conveniently listed and linked from this new Health Reform Implementation Web feature. Use the topics listed on the left to find what you need. 

Featured items are designated as

 

Health Resources and Research
NCSL ProgramsAccessCost & QualityDiseases & ConditionsHealth InsuranceHealth ITLong-Term Care & AgingMedicaid, CHIP, Medicare & SSI
Mental Health & Substance AbusePharmaceuticalsProviders & FacilitiesPublic Health & PreventionWomen, Children & AdolescentsSpecial Topics
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NCSL Health Programs

2013 Health Disparities Legislation

For a number of racial and ethnic minorities, good health is more difficult to attain because appropriate care is often associated with an individual's economic status, race and gender. Policymakers are responding to these issues by introducing legislation aimed at eliminating health disparities. More


 

LegisBrief: Newborn Health Screenings

Every year, thousands of infants are born with genetic disorders that can be identified by testing just a few drops of blood.  Early detection of many disorders can not only prevent disabilities, additional health problems or death, they may also save states and families money by avoiding high medical costs. More
 

Health Finance Issues

This report provides background and multiple resources on the $2.8 trillion world of US health finance, including latest figures released in 2013 showing much slower annual escalation in costs in the past three years. More

Medicaid Payment Reform 

States are seeking sustainable reforms that enable the Medicaid program to improve quality of health care services while reducing costs. State approaches and innovation models vary. Payment reform, however, plays a central role in many of these efforts. More

 

NCSL's 2013 Legislative Summit

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