Health Reform

Health Reform


Health Insurance Marketplaces, or Exchanges, created in the Affordable Care Act (ACA) have been open for enrollment for residents in each state since October. Read about recent activities in states and March 31 open-enrollment deadlines, with some extensions and exceptions. By Apr. 1st, some 7.1 million people had enrolled nationwide.  Another several million used exchanges to qualify for Medicaid. Each state's recent enrollment figures are listed.




This web report features a Medicaid ACA-related Expansion Map showing which states are currently moving forward with ACA-related expansion, not moving forward at this time, using an alternative method to expand or undecided.





The federal Affordable Care Act (ACA) aims to expand health coverage for up to 32 million uninsured Americans. It relies on a combination of health insurance reforms, insurance exchanges in all 50 states, Medicaid expansions, subsidies, tax credits and mandates. The law also allocates funds to improve quality and halts certain widely criticized insurance practices. The biggest changes came Jan. 1 2014 when Medicaid coverage expanded in about half the states and health insurance exchange or marketplace policies pay for care. States have considered and acted on hundreds of ACA-related laws, with more to do and decide for 2014. More than 950 ACA bills are being considered in 2014 state sessions.  Also, about 22 states have laws to restrict or oppose some reform provsions. Use the topics on the right to read about recent developments, optionsa and requirements.   [Updated 4/1/2014]


HHS releases new guidance and FAQs for state policymakers on a number of health reform implementation issues.




2014 ACA Database Expanded: NCSL has just released its latest compilation of state legislative actions related to the Affordable Care Act.  A new online database provides one-click access to almost 1,000 bills and resolutions filed or pending across the 50 states and D.C. Legislation can be sorted by state and by topics including Exchanges, Medicaid, Outreach, Insurance Reforms, Authorization & Funding or Challenges, Opt-outs & Alternatives.  As of this week, at least 75 measures have been signed or adopted. 


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NCSL Summit 2014


  • State Actions to Address Health Insurance Exchanges

    Read this NCSL report for 2014 information on state actions and responses to implement exchanges as outlined in the Affordable Care Act. This material includes links to implementation activities, with extended or postponed deadlines and enrollment figures by state. It also includes state information about insurers, premiums and allowing insurance renewals or cancellations.

  • Health Insurance Marketplace Updates

    Read recent updates following the 6-month open enrollment period for Health Insurance Marketplaces created in the Affordable Care Act (ACA) which ended March 31, 2014. State and federal rules allow new options and extensions for some consumers. Read about recent activities that affect state run and federally-facilitated marketplaces;

  • Health Insurance Reform Enacted State Laws Related to ACA

    More than 45 states have enacted one or more :Health Insurance Reform Enacted State Laws Related to the Affordable Care Act," between 2011 and 2013, with significant variations across the country. More such laws are being enacted in 2014 sessions.

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