The reelection of President Barack Obama has protected the fate of the Affordable Care Act (ACA) from repeal for now, but what is less clear is how Congress (with Republicans maintaining control of the House) will work with the Administration and the states to ensure that the law is fully implemented. Now that the election is over, and Congress and the President are back to work, it is less likely that the House will continue their efforts to repeal the law in its entirety from the last Congress. However, they can still propose dismantling parts of the law and impede the funding of provisions that require annual appropriations.
In addition, Governors who remain opposed to the ACA can pose barriers to implementation by refusing to set up state-based exchanges and opting out of expanding their Medicaid programs to include those newly eligible under the ACA. While both of these options are viable from a political standpoint, they are not as beneficial for the consumers who rely on these programs. The good news is that in either case, the Administration is looking at ways to ensure all uninsured Americans can still access coverage.
The deadline for states to decide if they will set up their own exchanges, or allow the federal government to come do it for them is quickly approaching. The initial deadline was November 16th but was recently extended to December 14th. Prior to the election the majority of states remained undecided, but since then states are becoming more vocal about their plans. However, there are a number of states that have yet to submit a formal response. Although some states are likely to change the details of their state plans in the coming months, the impending deadline will provide some prospective for the federal government’s plans for implementing the exchanges.
Although seldom reported to the general public, there are child welfare specific provisions in the ACA that are now one step closer to full implementation. For one, the Medicaid expansion for former foster youth, although still contingent upon state jurisdiction, provides an opportunity for transition age youth to remain insured. In the same vein, the Medicaid and CHIP expansions will also improve health care coverage for children and families in and at-risk of entering the child welfare system. Finally, ACA funds aimed at providing a unique opportunity to address some preventative measures including teen pregnancy and home visiting can continue.
For state-specific information for Medicaid and CHIP coverage for children and families, be sure to check out the Centers for Medicare and Medicaid’s InsureKidsNow website.