Coverage & Assistance

The Affordable Care Act establishes a national structure for financing health insurance coverage. State policies will determine how the law is transformed into coverage. Major coverage changes will occur in Medicaid where new eligibility rules will increase enrollment in the program by 50 percent across the country.  Other major changes will occur in private insurance where states will need to modify how they regulate insurance rates and variations among rates.  A new arena for coverage will be insurance exchanges, which will be the vehicles for providing subsidized insurance coverage to people with incomes greater than Medicaid levels but less than 400 percent of the poverty level. States will need to decide whether to establish these exchanges or to leave this task to the federal government. Regardless of the placement of the exchanges, each state will have a range of decisions and responsibilities related to: coordinating eligibility for subsidized insurance coverage with Medicaid eligibility and coverage; providing information to consumers about public coverage, subsidized private coverage and unsubsidized private coverage; and assuring a high quality of care. 

Many coverage issues included in the Affordable Care Act are not new to states. States have expanded public coverage, simplified enrollment systems, created medical homes to coordinate care, set quality standards, and developed rates and reimbursement systems. Previous work in the states will serve as the foundation for expanded coverage available through the Affordable Care Act.

Frequently requested reports -

State Implementation Entities to Implement the Affordable Care Act