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The National Association of States United For Aging & Disabilities publishes a monthly report that tracks key health reform initiatives occurring in the states related to managed long-term care, the Duals Demonstrations, Health Homes, 1915(i) & (k) State Plan Amendments, and the Balancing Incentive Program.

TAC's Health Reform Work

Health Reform News & Updates

Health Reform

With the signing of the Patient Protection and Affordable Care Act on March 23, 2010, along with its accompanying legislation, the Health Care and Education Reconciliation Act on March 30, 2010, President Obama set in motion a series of historic reforms to the United States healthcare system. The Affordable Care Act (ACA), as these two health care reform laws are referred to collectively, presents significant opportunities to improve access to quality, affordable health care for all Americans. The ACA includes numerous provisions that are likely to have an impact on people with disabilities such as:

  • Expanded access to the Medicaid program;
  • Improved access to behavioral health and substance use services;
  • More options for states to serve individuals in home and community-based settings as opposed to institutions;
  • Workforce development and payment reform initiatives designed to improve access to primary and preventative care services; and
  • Incentives for improved coordination between physical and behavioral health care.

On June 28, 2012 the Supreme Court ruled that the individual mandate portion of the ACA is constitutional. It was the majority opinion of the court that the Congress does have the power to impose a tax penalty on those who choose not to comply with the requirement to maintain minimum essential health insurance coverage. On the question of the Medicaid expansion, the court decided that Congress cannot take away all federal funding for states that elect not to expand their program. In other words, states that want to move forward with expanding their Medicaid program can and will receive federal funding in order to do so, but if a state does not want to expand, they cannot lose their federal funding for their entire program. Read the court's opinion.

Key provisions that went into effect January 1, 2014 include the Health Insurance Marketplace, which will provide consumers with a way to compare insurance plans in their state and apply for subsidies to help cover the cost of insurance, and Medicaid Expansion. The Insurance Marketplaces opened in every state on October 1, 2013, and states have the option to expand Medicaid eligibility to low-income, childless adults.

TAC Resources on Health Reform:

The Future of Medicaid Expansion & Effects on People Experiencing Homelessness

Medicaid Eligibility: Enrollment Pathway Considerations for Vulnerable Populations

Connecting with Medicaid: Strategies & Options for Providers of Services to People who are Homeless

Connecting with Medicaid: Strategies & Options for Providers of Substance Use Services

How Healthcare Reform Strengthens Medicaid's Role in Preventing & Ending Homelessness

Medicaid: Tools and Information for the Fight Against Homelessness, TAC Presentation at the July 2011 National Alliance to End Homelessness National Conference, Washington, D.C.

Other Health Reform Resources: Health Reform website of the U.S. Department of Health & Human Services (HHS)

HUD Resource Library Page for the Affordable Care Act (ACA) on the OneCPD Resource Exchange

Bazelon Center for Mental Health Law summaries & fact sheets

Kaiser Family Foundation summary of the law, implementation timeline & how health reform affects Medicaid

National Council for Community Behavioral Health summaries, facts sheets, implementation timelines & webinars