APHA Health Reform Update - June 2013

One year after the Supreme Court's ACA decision

June 28 marks the one-year anniversary of the Supreme Court’s decision upholding the Affordable Care Act. Join APHA and the National Health Law Program for a timely webinar: Affordable Care Act implementation one year post-decision: Medicaid expansion, preventive services and public health implications.

This free webinar will be on Wednesday, June 26 from 1 – 2 p.m. EDT. Register here. Space is limited and we encourage colleagues to watch in groups. If we reach capacity and you're not able to register, don't worry: it will be recorded and archived on our webinars page within a few days after.

New Prevention and Public Health Fund resources

APHA recently updated its Prevention and Public Health Fund fact sheet. In addition to providing an overview of the Fund and its importance, it now also includes a helpful breakdown of fiscal year 2013 funding after reductions and adjustments.

Updated information about the planned allocation of FY 2013 Prevention Fund dollars to specific programs is now available at HHS.gov. To compare these amounts to the president's FY 2013 request or previous year allocations, see the charts and issue brief on APHA's Prevention Fund webpage.

Trust for America’s Health also recently released a new report called The Truth about the Prevention Fund. It provides an overview of the fund and highlights communities that are effectively using Prevention Fund dollars.

Medicaid expansion updates

As 2014 approaches, many stakeholders are following states' decisions regarding the ACA Medicaid expansion. Kaiser Family Foundation reports that as of June 20, 23 states and the District of Columbia are moving forward with the expansion; 21 states are not currently planning to move forward with it; and six are still deciding. States can still opt in to the expansion after 2014, but the most generous federal contribution (100 percent of the cost of expansion) is only available in 2014. Still, no matter when a state decides to opt in, the federal contribution will always be at least 90 percent of the costs of covering the new population.

The June 2013 issue of Health Affairs, a leading health policy journal, focuses on Medicaid expansion and vulnerable populations. In one article, authors discuss their study of the potential impacts of states' decisions not to expand their Medicaid programs. At the time of their study, 14 states had indicated they wouldn't expand Medicaid. The authors estimated that under this scenario, "3.6 million fewer people would be insured, federal transfer payments to those states could fall by $8.4 billion, and state spending on uncompensated care could increase by $1 billion in 2016, compared to what would be expected if all states participated in the expansion."

The Health Affairs journal is subscription based, but its health policy briefs and blog are also informative and are available to all. A June 6 health policy brief, Premium Assistance in Medicaid, focuses on the emerging issue of states proposing to use Medicaid expansion funds to purchase coverage for people through the new insurance marketplaces, instead of covering them through Medicaid.

Finally, in late May, Families USA released the results of a poll on residents' views on Medicaid expansion in five southern states. Conducted by the Joint Center for Political and Economic Studies, the poll shows that an overall 62 percent of respondents support the expansion.

APHA's website has background information and resources on the ACA Medicaid expansion.

ACA funding opportunities

In May, we highlighted several ACA funding opportunities. One is still open: $1 billion for Health Care Innovation Awards, Round Two,"Testing and evaluation of new payment and delivery service models aimed at improving care, lowering costs and improving population health" (CMMI, letter of intent deadline June 28, application deadline Aug. 15).

Dialogue4Health and other organizations offered a webinar on this funding opportunity on June 14: $1 Billion in CMMI Innovation Awards: Opportunities for Advancing Community Prevention and Population Health. An archive of the webinar is available here.

Visit www.grants.gov for more information about ACA and other federal funding opportunities. Other funding resources include the HHS Grants Forecast and the Prevention and Public Health Fund Reporting Database.

ACA regulations and recommendations

An important part of implementing the Affordable Care Act is the federal rulemaking process, in which executive agencies issue guidance and invite public comment on the details of how the law will work. Recently issued health reform rules have addressed community health needs assessments, workplace wellness plans and employer-based insurance.

For a list of other recent regulations and guidance, and for more information about the regulatory process, visit APHA’s ACA Implementation webpage.

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