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Medicaid And Affordable Care Act

Medicaid and the Affordable Care Act

 The Affordable Care Act (ACA) was created and enacted into law in March of 2010. The Affordable Care Act is actually made up of two pieces of legislation. These are the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. Together these two acts expand Medicaid coverage millions of low-income Americans and make several improvements to both the Medicaid and the Children's Health Insurance Program (CHIP).

 

 

This article provides you with information about the Affordable Care Act and how it compliments Medicaid.

 

 

The Affordable Care Act was created to provide Americans with better health care by putting five health care reforms into place that would;

 

 

1. Lower Health Care Costs

 

 

2. Expand Health Care Coverage

 

 

3. Provide Quality Health Care For All Americans

 

 

4. Guarantee More Health Care Choices

 

 

5. Hold Health Insurance Companies Accountable

 

 

In March of 2012, the government released two rules that cover eligibility and enrollment policies which were intended to provide coverage for people that are eligible for Medicaid starting January 1, 2014. The rules also establish elibibily and enrollment for the Affordable Insurance Exchanges. The final rules also provides direction for the States' implementation of the Affordable Care Act.

 

 

There are several new provisions of the Affordable Care Act that you should be aware of. They are as follows:

 

 

1. Eligibility - This health care provision fills in the gaps of the current Medicaid coverage for the poorest Americans. This is done by creating a minimum eligibility level across the country.

 

 

2. Financing - Starting in 2014, coverage for eligible adults will be funded 100% by the federal government.

 

 

3. Benefits - People that are newly eligible for Medicaid will get a benchmark benefits package that includes the minimum essential benefits in the Affordable Insurance Exchanges.

 

 

4. Coordination with Affordable Insurance Exchanges - This allows individuals and families to apply for health care coverage using just one application and to have your eligibility determined for all insurance affordability programs through one single process.

 

 

5. Community-Based Long-Term Services and Supports - This includes a number of program and funding improvements that provides for long-term care and services in your home or community.

 

 

6. Quality of Care and Delivery Systems - This provides improvements in the quality of care and how that care is delivered and at the same time reducing costs.

 

 

7. Prevention - This provision provides for prevention, well-being, and public health at the local, state, and federal levels.

 

 

8. Dual Eligibles - There will be a new office created in the Centers for Medicare & Medicaid Services (CMS) that will coordinate care for people that are eligible for both Medicaid and Medicare.

 

 

9. Children's Health Insurance Program (CHIP) - This provision will extend funding for CHIP through 2015 and continues the authority for the program through 2019.

 

 

10. Information Technology Systems and Data - States will get the policies and financing structure that is needed to acquire the technology systems which will ensure the Medicaid systems will be in place for the January 1, 2014 for the Affordable Insurance Exchanges and for the expansion of Medicaid eligibility.

 

 

11. Provider Payments - States will get 100% federal matching funds for the increase in payments.

 

 

12. Program Integrity - There are several provisions that will increase program integrity in Medicaid. These include terminating providers from Medicaid that have been terminated in other programs, preventing inappropriate Medicaid payments or claims, and suspending Medicaid payments based on investigations or credible allegations of fraud.

 

 

13. Program Transparency - This provision will promote transparency with regards to Medicaid policies and programs. This involves meaningful opportunities for public involvement in the development of state and federal Medicaid waivers.

 

 

 


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