The recently passed federal health reform legislation, the Patient Protection and Affordable Care Act (PPACA), mandates significant activities on the state and federal levels aimed at increasing access to health insurance coverage for low income individuals and for Americans previously shut out of the health insurance market. PPACA includes significant changes to Medicaid--the largest source of federal dollars provided to the states--expanding eligibility and benefit requirements nationwide and radically increasing federal funding provided to states. Changes are scheduled to take effect on a staggered schedule, and the federal government has implemented interim measures to bridge the gap between the current financial difficulties at the state level and dates in 2013 and 2014 when new funding provisions come into effect. In addition to the coming changes to Medicaid, PPACA creates new state and federal partnerships in the creation of high-risk insurance pools and the implementation of new protections for consumers with private health insurance. These efforts will eventually segue into the creation of health insurance exchanges, a national mandate to purchase health insurance, and a host of new consumer protections banning abusive practices such as rescission and denial of coverage for pre-existing conditions. Success will require new levels of coordination and support between state agencies and their federal counterparts--and new opportunities at every level of government to ensure access to affordable and appropriate health care for all Americans.
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