Health Reform: Medicaid/CHIP

young child with doctor


States are seeking sustainable reforms that enable the Medicaid program to improve quality of health care services while reducing costs. State approaches and innovation models vary. Payment reform, however, plays a central role in many of these efforts.





  • 2014 ACA Database Expands: NCSL has just updated latest state legislative actions related to the Affordable Care Act. The online database now provides one-click access to 1,102 bills and resolutions. Legislation can be sorted by state and by topics, including Exchanges, Medicaid, Outreach, Insurance Reforms, Funding or Opt-outs & Alternatives. As of July 14, at least 168 measures have been signed into law or adopted.
  • Health Reform 2011-2013 State Legislative Tracking Database. Enter topic as  "Medicaid".




In 2014, the Patient Protection and Affordable Care Act (ACA) will give states the option to expand Medicaid to most people with incomes up to 133 percent of the federal poverty guidelines ($15,282 for an individual and $31,322 for a family of four in 2013). This will for the first time, allow any state to choose to extend eligibility to childless adults, beginning in 2014 or in a future year. The federal law will provide federal financing (FMAP) for all newly eligible individuals according to the following schedule: 100 percent FMAP for 2014 to 2016; 95 percent FMAP for 2017; 94 percent FMAP for 2018; and 90 percent FMAP for 2020 and beyond.

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NCSL Summit Resources


  • Medicaid and Marketplace Outreach and Enrollment

    This page contains information about who has signed up for health insurance coverage through insurance marketplaces and state legislation related to attracting and enrolling newly eligible individuals into health coverage.

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