Affordable Care Act (ACA)

States are confronting challenging budgets along with the need to implement health reform. Many are looking to improve long-term care as a way to control costs and serve seniors and people with disabilities in settings they prefer. This newsletter describes provisions in the Affordable Care Act that assist states in expanding HCBS, the growing movement to improve facility-based care, and innovative programs in three states that seek to provide consumer-directed long-term care.

The Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) held a briefing to examine the challenges facing states as they continue to struggle with the lingering impacts of the recession and begin preparing to implement health reform. Find links to three reports released at the event, archived presentations, video, podcast, transcript, agenda and more.

To better understand the dynamics of the workforce challenges that factor in to the implementation of health reform, an initiative was undertaken to examine the situation in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). These states represented a range of geographic and political experiences as they continued to struggle with the lingering impacts of the recession and began preparing to implement health reform. Six key findings are summarized.

What specific provisions in the new law pertain to rural health care? This briefing looked at current health care policy initiatives pertaining to rural issues, with a special focus on information technology, and the opportunities and challenges that the reform implementation presents. Review the briefing's archived webcast, podcast, presentations, transcript and source materials.

Five innovative states (Arizona, Hawaii, Tennessee, Texas, and Wisconsin) with demonstrated expertise in managed care approaches for individuals with long-term care needs are featured in this report. The resulting “roadmap” outlines 10 critical mileposts for successfully designing models for managed LTSS. It also identifies key ACA provisions that support state efforts to improve long-term care delivery.

To provide a look at the various provisions of the new health reform law on LTC, a distinguished panel of experts addressed questions such as: What are the provisions of the law pertaining to LTC? How will consumers, providers and states be affected? What are the major components of the CLASS Act, and what are some of the challenges for states and the federal government in implementation? Access the presentations, transcript, event summary, podcast and more.

A conference was held to inform potential solutions to improve the cost and quality of care across the health care continuum for older Americans. Synthesizing the conference, this report addresses many of the challenges facing individuals with chronic conditions and functional impairments, and identifies new opportunities for the integration of medical services and social supports tailored to older Americans and supported by new payment designs.

Implementation of ACA will raise a number of issues for working people with disabilities currently receiving Medicaid, especially regarding how the Acts’ provisions will interact with the programs that currently provide them access to care. This brief addresses challenges such as these, succinctly delineating data-supported lessons learned by the MIG grantees in their experience with the program, and future needs associated with them.

For the tenth consecutive year, a survey of Medicaid officials in all 50 states and DC was conducted to track trends in Medicaid spending, enrollment and policy initiatives. Findings are presented for FYs 2010 and 2011. As states grapple with historically difficult budget conditions, they must also plan for the implementation of the ACA. Review this report including background on the Medicaid program, as well as current issues the program faces.

Despite the current budget climate that has dampened the pace of some rebalancing efforts, 32 states expanded Medicaid long-term services and supports in FY 2010 (primarily expanding HCBS programs) and 32 states planned expansions for FY2011. This updated fact sheet provides an overview of long-term care services, delivery of such services, and the large role Medicaid plays in financing long-term care.