What's New
- NEW!: Defining an Effective Change in Scope Process, Emerging Issues #6
- NEW! Update on the Status of the FQHC Medicaid Prospective Payment System in the States - State Policy Report #40
- NEW! Calculating the Cost: State Budgets and Community Health Centers, State Policy Report #39
- NEW REPORT: Emerging Issues in the FQHC Prospective Payment System, State Policy Report #38
- NEW ISSUE BRIEF: Summary of Key Provisions of a Proposed Rule Establishing Health Insurance Exchanges and Qualified Health Plans, Spotlight on the States #4.
- NEW REPORT: State Legislation Impacting Health Centers in the 2011 Legislative Session, State Policy Report #37
- NEW ISSUE BRIEF: Reaching and Enrolling Kids and Families, Promising Practices #7
- NEW ISSUE BRIEF: Emerging Issues #4: Key Impacts of the Affordable Care Act, Other Recent Federal Policies & State Fiscal Conditions on Hospitals
- NACHC Suggested Legislative Language on Health Center Payment and Participation provisions in Health Insurance Exchanges
Get the Full Stories and View More Updates
State Policy Issues Impacting Health Centers
Health Care Reform - States will play a complex and important role in the implementation of the new federal health care reform law. For many states, this will also mean integrating new requirements with prior health reform efforts. The expansion of Medicaid and establishment of new health insurance exchanges are just two of the major undertakings states face in the coming years that will have a direct impact on health centers and their patients.
Funding for Health Centers - State support to supplement federal investments in health centers is critical for their continued growth and success. Just over $400 million in state funds were directed to health centers in SFY2010 to pay for uncompensated care, services and operations, capital projects, health information technology, loan repayment programs and health center incubator programs. State funding to health centers has been on the decline since SFY2008 and is expected to decline further in SFY2011 as the vast majority of states continue to face significant budget shortfalls.
Medicaid - The joint Federal/State program accounts for approximately 36% of health center revenue and covers over 35% of health center patients. States have great flexibility in how they can structure their programs including eligibility and benefit design. With the sizable expansion to 133% FPL under the new health reform law, state administration of Medicaid becomes an increasingly important focal point.
Children's Health Insurance Program (CHIP) - The reauthorization of CHIP in 2010 provides coverage for up to 11 million children, many of whom rely on health centers for their health care needs. Like Medicaid, CHIP is administered by the states and determination of eligibility levels and benefit design are left to state policy makers within federal guidelines.
Health Center Reimbursement - Health centers are reimbursed by Medicaid and CHIP based on a Prospective Payment System (PPS). Beginning in 2014, health plans operating in state-based insurance exchanges will be required to pay health centers no less than the PPS rates paid by Medicaid.
Outreach and Enrollment - Health Centers help a significant number of individuals gain access to health coverage daily through outreach and enrollment activities. With the passage of the Affordable Care Act outreach and enrollment will be vital to help the millions projected to gain access through Medicaid, CHIP and Health Insurance Exchanges. Activities that are innovative and strategic will identify, educate and enroll those who are eligible in a way that is both timely and efficient.
Resources
Toolkit: Educating New State Officials UPDATED January 2011
State Legislation Tracking - Browse health center-related legislation in all 50 states and the District of Columbia in REAL TIME!
Click Here for the State ACCESS Planning toolkit, ER Diversion toolkit and more!
