As states move forward with Exchange planning, key stakeholder groups are providing input on Exchange design, governance and functions. This input on specific policy decisions can help planners generate new ideas, create participant buy-in, and add transparency to ACA implementation. At State Refor(u)m, we’re following what states are doing to solicit input from small businesses, industry experts, consumer advocates, providers, and other Exchange stakeholders. read more
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States Make Strides on Commercial Insurance Legislation
While many of us have been actively monitoring the status of state Exchange legislation, state efforts to bring other state laws in line with the ACA have gone relatively unnoticed. We took a look at the resources posted to the State Refor(u)m milestone, “Enact legislation necessary to bring the state into compliance with federal law,” and found that many states have already passed commercial health insurance reforms. read more
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Taking it to the People: Engaging the Public in Health Reform Implementation
Educating the general public about the ACA and soliciting input on policy decisions are crucial tasks for state policymakers. Unlike key stakeholder groups, members of the public typically lack an in-depth knowledge of the law, and communicating on these issues can be challenging. A recent Kaiser Family Foundation poll found more than half of respondents said they did not have enough information about the law to know how it would affect them personally. read more
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Highlights from the First Batch of Exchange Establishment Grants
HHS recently awarded the first batch of Exchange establishment grants to Indiana, Rhode Island and Washington. The grant funds, larger than the initial forty-nine planning grants, and ranging from five million to twenty-two million dollars per state so far, are targeted to help states build Exchanges. The grant application requires states to address eleven core areas identified by HHS in which states are expected to carry out activities. read more
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An Early Taste of ACOs

Medicaid Managed Care and the “Three-Legged Stool”
As states confront budget pressures and prepare for Medicaid expansions in 2014, Medicaid managed care is again a hot topic. Last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) convened to discuss this issue. As of 2009, more than 71 percent of Medicaid beneficiaries nationwide were enrolled in managed care. read more
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State Exchange Update: Bills, Bills, Bills
As state legislative sessions wind down, activity around Exchanges is heating up. Three states (California, West Virginia, and Maryland) have enacted Exchange establishment legislation and Virginia has enacted legislation stating an intent to create an Exchange. read more
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Talking SHOP: The ACA & Small Businesses
Did you get your tax return postmarked by midnight on April 18? Up to 4 million small businesses in the U.S. were eligible for a new health insurance tax credit this year, as part of the ACA. The credit, which took effect in 2010, tries to encourage small businesses to start or continue offering health insurance to low- and moderate-wage workers. read more
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Mind the Gap: Emerging Roles for Non-Physician Health Care Providers
As of December 2010, 66 million Americans lived in a primary medical health professional shortage area, while only around 10 percent of physicians practice in those areas. read more
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Casting Call: Medicaid’s Role in the Exchange
Will Medicaid play a starring role in the state health insurance Exchanges? Or will it be a supporting actor or even an “extra”? These questions seem to be coming up a lot lately. read more

