While the legislation needed will vary by state, it is reasonable to expect that every state will need to enact new or modify existing laws as part of its implementation effort.

*Milestone details:

*Full name: Enact state laws to make required changes.

*Relevance to the ACA:

ACA implementation requires changes to state law, some immediate and some over time. In some instances, the federal government will take action if implementation deadlines are not met. The ACA recognizes the time constraints on state legislatures by granting extensions in some instances. Given variations in existing state laws and legislative processes, each state will have its own approach to enacting laws. Some provisions with deadlines relevant to new state laws are:

§1001, §1003, §1201 - Make immediate changes to commercial insurance regulation.

§1304 – States must decide whether they will define small groups as no more than 100 employees or no more than 50 employees.

§1311 – States must demonstrate sufficient progress toward implementing an insurance Exchange by January 1, 2013.

§2301 – Allows states to delay Medicaid coverage of freestanding birth center services if state legislation is required to begin making payments.

§6507 – Delay of National Correct Coding Initiative requirements in Medicaid and CHIP if state legislation is required.