States Continue to Respond to Federal Health Reform Requirements 

Passage of the Affordable Care Act, or federal health reform, one year ago, created a lengthy to-do list for states. Many already had a jump on the federal government, and every state has made some progress in implementing the new law.

The National Conference of State Legislatures (NCSL) has launched the first of its kind database to track the actions of state legislatures related to some of the major provisions in the Affordable Care Act.

Topics in the database include Medicaid, Health Insurance Exchanges, Health Insurance Reform, Health Information Technology, Prevention and Wellness, and Providers and Workforce.

The database also includes bills that oppose, opt out or differ from elements of the federal provisions, under the topic Challenges and Alternatives.

“States are at different starting places to implement health reform; the roughly 600 bills included in the database vary so far, depending on the state,” said Martha Saenz, a health policy analyst at NCSL. “Introduced bills deal primarily with some of the state flexibility, such as establishing health insurance exchanges.”

Federal health reform was passed by Congress and signed by the president in March 2010. This left little time for state policymakers, especially in part-time legislatures, to take action on bills. 2010 was also a short or no-meeting year for several state legislatures. This session, lawmakers are responding to the numerous requirements and options outlined for states in federal health care reform.

The database includes 2011 legislation, including pending, failed and enacted bills and resolutions. Bills can be searched by state, topic, keyword, status, and/or primary sponsor. The 2011 State Legislative Database is online, free to all web users.

2010 state actions to implement health care reform, including legislation, can be found separately on NCSL’s website. State actions that challenge certain health provisions can also be found on NCSL's website.

NCSL is a bipartisan organization that serves the legislators and staffs of the states, commonwealths and territories. It provides research, technical assistance and opportunities for policymakers to exchange ideas on the most pressing state issues and is an effective and respected advocate for the interests of the states in the American federal system.