Managing State-Level ACA Implementation Through Interagency Collaboration
Shelly Ten Napel, MSW, MPP, Kyla Hoskins, MPH, Enrique MartinezVidal, MPP and Heather Howard, J.D
“Managing State-Level ACA Implementation Through Interagency Collaboration” was developed by Shelly Ten Napel and the State Network team to describe the early lessons learned from state officials and technical experts related to the leadership and coordination strategies needed to successfully implement the Affordable Care Act (ACA) at the state level. The brief:
– Discusses the value of leadership and a clear vision;
– Outlines specific interagency collaboration strategies being used by states, from low-tech solutions, such as regular meetings and clear delineation of roles and responsibilities, to higher-tech tools including document-sharing and project management software;
– Provides concrete examples of work plans and formal memorandums of understanding (MOUs); and
– Explores issues raised by:
– the need to procure and develop new information technology (IT) systems;
– the imperative to consult with various stakeholders; and,
– the unique challenges related to Health Benefit Exchanges (Exchanges), which may or may not be a formal part of state government.
The brief is designed to provide practical insights and tools for states. For states in which planning is already well underway, it provides suggestions on ways to get beyond existing challenges and barriers. It can be used to check current task lists to ensure that all important topics are being contemplated. For states in which planning is just getting started, it can serve as a comprehensive primer. You will find the following tools:
– Model high-level Exchange timeline
– Milestones for ACA implementation
– Exchange work plan template
– Division of Insurance work plan template
– Division of Insurance self-audit timeline
– Medicaid work plan template
– Checklist of areas where Exchanges will need MOUs with Medicaid programs and Divisions of Insurance
On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (the ARP), a wide-ranging package of health care and economic measures responding to the coronavirus pandemic. The ARP includes a broad expansion of the Affordable Care Act’s (ACA) main health insurance subsidy, the premium tax credit (PTC), the first major expansion of the health care reform law since its passage. This piece highlights the policymaking considerations that states must account for in light of the PTC expansion and uncertainty about future federal action. A key theme that emerges is that states will benefit from approaches that give them the flexibility to adjust policies year by year as the federal landscape develops.