Webinar Resources Health Reform: What Next for States? Feb.4. Webinar description Download or request slides and audio Contact: Health Staff

State Actions and Legislation Overview

State governments already have made decisions and are responding  to federally established implementation deadlines. 

NCSL has numerous resources — reports, briefs, legislative tracking and summaries, multimedia and meeting sessions — all aimed at helping state legislatures and policymakers learn about state actions and options. 

On June 28, 2012 the U.S. Supreme Court upheld most provisions of the Patient Protection and Affordable Care Act, but rejected the portion of the law that would have penalized states that did not comply with the expanded eligibility requirements for Medicaid. The 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 latest NCSL information and analysis at U.S. Supreme Court and the Federal Health Law.

Here is a sample of recent and popular items: ► 

• Affordable Care Act: State Action Newsletter highlights state actions (that the state is taking or will need to take) related to the federal Affordable Care Act of 2010. The newsletter includes health reform implementation happenings in the states.
• State Actions to Implement the American Health Benefit Exchange - A tally of state actions taken to implement health insurance exchanges.
• State Implementation Entities, Reports, and Research - provides access to state-based  reports, research papers, fiscal analyses, web-sites, timelines and presentations related to the Patient Protection and Affordable Care Act.
• Health Insurance Reform Enacted Laws Related to the ACA - tracking new state laws implementing immediate or early market reforms and expanded features for 2014, in almost every state.
• Health Reform State Legislative Tracking Database - latest listings, with summaries and status of more than 900 measures introduced in 2011; 869 measures considered in 2012 and 630 bills introduced in 49 states in 2013. Updated online every two weeks.

• State Actions Challenging Certain Health Reforms - 20 states have enacted binding measures, usually opposing individual and employer mandates; 30 others declined to do so.  This report includes highlights of the five states where voters said yes and no on health reform on November 6, plus federal court activity in 2012 and 2013.

  
  Specific Programs and Provisions  
• Medicaid: Health Reform Expansion - featured Webinar, February 1, 2013
• State Health Insurance Mandates and the PPACA Essential Benefits Provisions - A review of how the PPACA coverage requirements are affecting the 1,800+ existing state mandate requirements.  Updated 2013.
• Pre-Existing Conditions Insurance: State and Federal High-Risk Pools - all 50 states now have insurance at standard rates for patients with costly conditions. Updated 2012.
• Adult Dependent Insurance Coverage - a new option for family coverage for young adults up to age 26.

• State Approval or Disapproval for Health Insurance Rate Increases - expanded options and authority to review premium rates before they take effect.

• Health Reform and Abortion Coverage in the Insurance Exchanges - some states proposed or enacted state laws specifying abortion policy within their state exchanges.
• Out-of-state Health Insurance - Allowing Purchases - Reports on four states wth laws, out of 20 that have considered such legislation.
• Archive: States Implement Health Reform Briefs- NCSL has produced a series of brief reports about topics contained in the federal health reform law.
• Visit for a more complete listing, by dates or titles. 

PPACA SNAPSHOT
The federal health law aims to expand coverage to 32 million more Americans. It relies on a combination of 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 2014 when Medicaid expands if states select to do so and states create exchanges for health insurance.

The federal law provides competitive grants and funding options to help states set up plans for exchanges, and implementation for consumer assistance offices, review of insurers’ rate hikes, support for home nurse visits to high-risk pregnant women, and provide sex education and abstinence programs, among other things. The law also directly allocated $11 billion to support community health centers.

• January 2013