Financing & Grants Overview 

Final language in the Affordable Care Act left many questions about financing health reform activities unanswered. States are already struggling to balance their budgets for existing programs in an environment of shrinking revenues. Medicaid programs facing budget cuts in FY 2011 now must find a way to plan for a massive expansion of the program in FY 2014. In fact, the Congressional Budget Office has estimated state spending on Medicaid and the Children’s Health Insurance Program (CHIP) will increase by $20 billion between 2010 and 2019. 

Understanding that states cannot do this alone, the Affordable Care Act provides a number of funding opportunities and grants to help states implement new programs.   

Not every financing program established in the legislation was automatically funded, and, as a result, must go through a second level of scrutiny in order to receive funding. NCSL follows the opportunities available for states to receive additional financial support for their health reform efforts.

For more information, contact Rachel Morgan in NCSL's Washington, D.C., office.