The Affordable Care Act (ACA) provides states with some important tools that can be utilized to provide more continuous, adequate and affordable coverage for children with special health care needs (CSHCN). How the law is interpreted and whether implementation challenges are addressed with the unique needs of CSHCN in mind will shape how well the ACA fulfills its promise to this vulnerable population. This paper developed by the National Academy for State Health Policy (NASHP) for the Catalyst Center at Boston University reviews and analyzes key provisions of the ACA relevant for CSHCN and provides suggestions for state policymakers.
Charting CHIP IV: A Report on State Children’s Health Insurance Programs Prior to Major Federal Policy Changes in 2009 and 2010 is the fourth in a series published by the National Academy for State Health Policy (NASHP) since 1998. The report paints a portrait of state Children’s Health Insurance Programs (CHIP) as they stood in mid 2008, roughly a decade after the federal CHIP program was enacted, a half year before CHIP was reauthorized, and just short of two years before national health reform legislation was enacted. This report examines state program characteristics and policies for both Medicaid expansion (M-CHIP) and separate (S-CHIP) programs in a range of areas, from program structure, to eligibility, outreach and enrollment, to benefits and cost sharing, to service delivery, access and quality.
States have significant roles in implementing practically all aspects of the Affordable Care Act. The Act gives states additional options for financing Medicaid home and community based services and supports (HCBS) through a combination of enhanced Medicaid matching payments, demonstrations, and new Medicaid state plan options. They include the State Balancing Incentive Payments Program, the Money Follows the Person Rebalancing Demonstration, State Plan HCBS, and Community First Choice Option. This issue brief analyzes the scenarios under which states might adopt them. In making those determinations, states will assess whether the new options improve upon the Medicaid authorities they currently use to finance HCBS, namely Medicaid 1915(c) HCBS waivers and state plan personal assistance.