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
A range of policy proposals to cut federal Medicaid funding under consideration by Congress could profoundly reshape the Medicaid program. Although the specific details of these proposals have not yet been defined, many entities are actively analyzing the possible effects on state Medicaid enrollment and spending. This expert perspective highlights the national 50-state analyses of Medicaid cuts that have been released. SHVS will continue to regularly monitor published estimates and update this expert perspective.
The budget reconciliation process is continuing to move forward in Congress and includes developing proposals in the House to identify $880 billion in federal savings over the next ten years, the vast majority of which will need to come from Medicaid. To support states in informing and validating their own fiscal and program impact estimates of federal policy changes, Manatt Health has developed, with support and input from State Health and Value Strategies, a new toolkit providing national and state-by-state data on the potential impact of key cuts under consideration in Congress. This expert perspective provides an executive summary of the toolkit.
Congress is considering a variety of federal policy changes that will have significant impacts on the Medicaid program, widely expected to reduce enrollment and federal Medicaid funding to states. A variety of state-level estimates have been released, which can be helpful for states as they consider how various policy proposals might impact their Medicaid programs. This expert perspective highlights state agencies that have estimated and quantified the potential impacts of various proposals on enrollment and spending. SHVS will continue to regularly monitor published estimates from states and update this expert perspective.
