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Latest Resources to Make Health Reform a Reality

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Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Latest Resources to Make Health Reform a Reality

February 1, 2013 | Uncategorized | Comments
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mohini venkatesh discusses health reform resources

Mohini Venkatesh, Sr. Director, Public Policy, National Council

By Guest Author Mohini Venkatesh, Senior Director of Public Policy, National Council

I don’t know about you, but I’ve noticed a sudden rush in health reform-related resources arriving in my email inbox. Maybe it’s because we’re past the elections or because many of the big (and controversial) provisions of the Affordable Care Act are launching in less than year. Whatever the reasons, we know it’s hard to keep up with everything that’s going on in your state.

These resources emphasize:

  • States are really customizing Obamacare to their populations, so for you, this means that knowing about your state’s decision-making and implementation process will put you at the front and center of what health reform will look like for your community.
  • Many decisions have already been made, like whether to expand Medicaid or who will run the new private health insurance marketplace in your state. But many decisions have not been made, like what benefits will be offered to newly-eligible individuals or what protocols are being put in place to assist people with enrolling in insurance
  • New programs are being established to help “special populations”, including people with chronic health issues like serious mental illness, and states and providers have already begun taking advantage of these opportunities.

Want more details? Check out these documents and let us know if you have questions or thoughts on what’s going on with Obamacare implementation.

 

Exchanges

ACAP: Improving Risk Adjustment In Health Insurance Exchanges to Ensure Fair Payment

The Association of Community Affiliated Plans provides a review of the risk adjustment measures that will be in place within the Exchanges to ensure individuals with high health needs are enrolled as beneficiaries.

CMS: Health Insurance Exchange Update – State – by – State Implementation Update

Last week, HHS awarded an additional $1.5 billion to support states building Health Insurance Exchanges. This interactive map provides a status update on each state’s implementation activities

Kaiser Family Foundation: Essential Health Benefits: What Have States Decided for Their Benchmark?

Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). Click on the “review of state’s decisions around EHB” link to find out what plan (if any) your state has selected for the EHB benchmark.

 

Medicaid

National Council: Expand Medicaid to Support Your State’s Economy

Knowing that states are evaluating the economic arguments in favor of and against the expansion, the National Council has issued a set of talking points for advocates to use in states that may be hesitating to expand Medicaid. The talking points cover the hidden costs of failing to expand Medicaid, the cuts to uncompensated care payments that may occur in non-expansion states, the effects on business, and more.

Kaiser Family Foundation: Findings From a 50-State Survey of Eligibility, Enrollment, Renewal and Cost-Sharing Policies in Medicaid and CHIP, 2012-2013

As of Jan. 1, 2013, 47 states had applied for or received increased federal funds to make major upgrades to Medicaid enrollment systems, and 42 states had already begun their system development work, according to the survey, conducted with the Georgetown University Center for Children and Families. Federal regulations released in 2012 outline the requirements for all Medicaid programs to have web-based, paperless, real-time enrollment processes that will rely on electronic data and minimize administrative burdens on individuals and eligibility workers. The survey provides a snapshot of Medicaid and CHIP enrollment and eligibility policies and procedures and highlights the changes that states will need to make in their programs to prepare for the ACA in 2014.

RWJF/Urban Institute: Progress in Implementing Selected Medicaid Provisions of the Affordable Care Act

Examines progress in implementing selected Medicaid provisions in 10 case study states. The report finds that although all 10 are working on many different fronts to prepare for the 2014 expansions, only two are expected to fully expand Medicaid before 2014. Focus on: modernizing eligibility and enrollment systems, dual-eligibles, and the Basic Health Plan

Kaiser Family Foundation: Medicaid Eligibility and Enrollment for People with Disabilities Under the Affordable Care Act: The Impact of CMS’s March 23, 2012 Final Regulations

This issue paper provides a short summary of Medicaid eligibility and benefits for people with disabilities today and explains how these issues will be affected by health reform in light of CMS’s new regulations. Provisions of the new Exchange regulations are discussed briefly to the extent that they relate to Medicaid eligibility determinations for people with disabilities.

 

Demos/Special Populations

CMS: State Medicaid Director Letter: Health Home Core Quality Measures Guidance

This State Medicaid Director letter shares a recommended core set of health care quality measures for assessing the health home service delivery model that CMS intends to promulgate in the rulemaking process. While CMS is not requiring states to use these measures until the regulations are promulgated, the core set is being shared to help states as they consider the design and implementation of their health home programs, as well as provide time for states to share information with their health care providers. Included in the 8 measures are: Follow-Up After Hospitalization for Mental Illness, Screening for Clinical Depression and Follow-Up Plan, and Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

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