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State Implementation of the Affordable Care Act: Practical Concerns Final

This is a talk I gave at University of Maryland Law School on MArch 1, 2013.
by Sonya Schwartz on 4 March 2013

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Transcript of State Implementation of the Affordable Care Act: Practical Concerns Final

Limited public awareness
Uninsured is a diverse group
Public education campaign
grassroots
social media
earned media
paid advertisements
partnerships- public and private Federal Exchange "Plus" Model Emerging? 3 States have a love-hate relationship with federal regulations Governance battles are playing out within states 8 Exchanges will not start as an active purchaser in most of the country, but this could change 7 Some state-based health insurance exchanges have created new models of transparency and stakeholder engagement 5 All but three states have a long way to go to align with ACA's commercial insurance market reforms 4 The Medicaid expansion decision gets all the attention, but it is only one decision on a state’s long Medicaid related ACA to-do list 1 It is now “prime time” for states implementing the health reform law 9 So much depends on who enrolls and not just how many enroll 6 Takes only a minute to create a profile
and connect with more than 5,000 health reform thinkers and doers
statereforum.org/user/register See what states
are
talking about Ask a
Question See You Online!
www.statereforum.org Share Your
Presentations,
Analysis, Research
and Ideas Expand Medicaid? Benefits
Alternative Benefit Plans
New Preventive Benefits Standards Coverage Operations
IT System Upgrades
Safeguarding Information
Increase in Primary Care Reimbursement Rates Financing
Enhanced CHIP FMAP
Enhanced Federal Funding Eligibility and Enrollment
Maintenance of Effort
Mandatory Coverage Expansions
New Income Eligibility Rules Medicaid-Related ACA Reforms Attorney General Hood Gary Cohen, CCIIO Federal Partnership Exchanges Plan Management Consumer Assistance Both State-based exchanges are another opportunity for states to align their health policy vision and goals 2 Example #1 Mississippi 10 All the work will not be done on Jan 1, 2014. Do your part to help your state succeed now and in 2014 and beyond! Iowa Arkansas
Delaware
Illinois
Michigan New Hampshire
West Virginia Insurance Commissioner Chaney Consumer Assistance
Consumer Facing Site
Multiple Options
Accessibility Guidance Final Regulation Proposed Regulation Ways to help your state succeed: 2014
is today Medicaid Expansion as
crafted in ACA unconstitutional

State choice to
expand or not SCOTUS CMS We need flexibility

Let us do a partial
Medicaid expansion If you want the 100%
match rate, you have to expand all the way to 138% FPL Governors'
Appeal to
HHS EHB Regulations Guidance on Partial Medicaid Expansion Check out "highlights" like tracking charts on Medicaid and Exchange Policy Decisions Market research around communications and public awareness
Segmenting audiences
Using trusted community organizations
Media buys through radio, TV, print materials Number of days until open enrollment: 214

Number of Days until coverage starts: 306 Gather ideas from other states that might solve problems in your state.

In state exchange states, participate and provide input into policy decisions happening now.

In federally facilitated exchange states, focus on state role regulating insurance and assisting consumers.

Educate your students, the media, colleagues, and friends and family on the ACA, states role in making it work, and who to hold accountable.

Contribute to scholarship or grey literature as issues emerge about what is working and what isn't. How might emerging problems be solved? What are the state and federal legal, regulatory, and policy and practice fixes needed to improve? 1. It is now “prime time” for states implementing
the health reform law
2. Governance battles are playing out within states
3. States have a love-hate relationship with federal regulations
4. The Medicaid expansion decision gets all the attention,
but it is only one decision on a state’s long Medicaid related ACA to-do list
5. All but three states have a long way to go to align with ACA's
commercial insurance market reforms
6. State-based exchanges are another opportunity for states to
align their health policy vision and goals
7. Some state-based health insurance exchanges have created new
models of transparency and stakeholder engagement
8. Exchanges will not start off as an active purchaser in the majority
of the country, but this could change
9. So much depends on who enrolls and not just how many enroll
10. All the work will not be done on Jan 1, 2014.
Do your part to help your state succeed now and in 2014 and beyond! State Implementation of the
Affordable Care Act:
Ten Practical Considerations Governor Bryant
See the full transcript