Affordable Care Act (ACA)

This critical essay examines how effectively the Patient Protection and Affordable Care Act (ACA) addresses prevailing deficiencies in the nation's long-term care system and whether the ACA will result in meaningful reform. This article also reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them, including incentives/options for expanding home- and community-based care and a number of research and demonstration projects.

The coordination of Medicare and Medicaid benefits and services for dually eligible enrollees has been a longstanding policy challenge. Several provisions of the Affordable Care Act (ACA) attempt to address this lack of coordination. This paper reviews the major changes under the ACA directed at care coordination for the dually eligible population and then concludes with a discussion of the continuing legislative and legal challenges in integrating care for the dually eligible.

A statistical model was developed to assess the effect of rebalancing on overall spending for long-term services and supports (LTSS). The model indicates that spending is affected by the way rebalancing is implemented: Gradual rebalancing can reduce spending by about 15 percent over ten years. Because many states continue to experience budget crises, policy makers must think carefully before altering spending patterns for LTSS and adopt strategies to successfully reduce overall spending.

This study addresses issues related to the provisions of home and community-based services (HCBS) under the Affordable care Act (ACA) legislation of 2010. ACA allowed important voluntary provisions for the expansion of HCBS under Medicaid. Although the new provisions are valuable, the law does not set minimum standards for access to HCBS, and the new financial incentives are limited especially for the many states facing serious budget problems.

States have continued to rebalance their long-term services and supports (LTSS) toward more home and community-based services (HCBS). This report uses diverse methods to assess the different incentives affecting states’ decisions to implement the four Medicaid HCBS options under the Patient Protection and Affordable Care Act (PPACA); two new options (Community First Choice and the Balancing Incentive Program) and two existing [Money Follows the Person and 1915(i)].

As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care arrangements, and raise issues to consider for proposed reforms aimed at better coordinating their care and reducing health care spending.

This document outlines the Department of Health and Human Services’ (HHS) approach to implementing a Federally-facilitated Exchange (FFE) in any State where a State-based Exchange is not operating. This report also provides general guidance on how states can partner with HHS to implement selected functions in an FFE, key policies organized by Exchange function, and how HHS will consult with a variety of stakeholders to implement an FFE.

The Centers for Medicare and Medicaid Services (CMS) is currently working with states to design and implement new models for integrating the benefits and financing of both programs. This website is designed as a resource for advocates, providing resources, background information and, most importantly, in the Advocate Tools section, concrete recommendations that advocates need to engage constructively with their states to ensure that new models improve care for dual eligibles.

In 2014, most homeless people will become Medicaid-eligible under the Affordable Care Act. Many homeless people have physical and behavioral health conditions for which they seek care through frequent use of emergency rooms and inpatient hospitalization, at considerable cost in public resources. Medicaid reimbursement is an important source of funding for services that help homeless people succeed in housing and stop such inappropriate use of crisis health services.

This is the second “year in review” of developments in family caregiving, and there remains considerable room for improvement in how this nation supports the over 42 million family caregivers (and growing) who provide an estimated $450 billion in “free” care annually. The guide provides an overview of key developments in 2011. Two shorter versions, "45 Facts About Family Caregivers" and "27 Things You May not Know about Women and Caregiving" are also available.