The Affordable Care Actand What To Write About It

JULY 23, 2012 THE NATIONAL HEALTH JOURNALISM FELLOWSHIP

The ACA = Health Story Goldmine

States play a crucial role in implementing the health reform law.

They hold big sway over three key provisions: Health Insurance Exchanges Medicaid Expansion Prevention and Public Health

Health Exchanges
The Affordable Care Act requires every state have a

new insurance market in 2014

The goal: an Expedia for health insurance
The big decision: every state will have an

exchange, even if they dont want it. Do states set up a health exchange themselves, using federal funds, or leave the task to the federal government?

Health Exchanges: State of Play

Democratic Governors
Aggressive Implementers California Connecticut Massachusetts Oregon

Republican Governors
Aggressive Opposers Alaska Florida South Carolina Wisconsin Texas
Passive Opposers Georgia Indiana Pennsylvania Tennessee

Passive Implementers Illinois West Virginia Delaware Minnesota New York Kentucky

Health Exchanges: Three Story Ideas

Exchanges 101: what is an exchange and how many

residents of your state is it expected to insure?

Where is your state on planning an exchange? What

grant money has been received and how is it being used? Is there pushback?

How are various interests insurers consumer

advocates, hospital groups shaping the exchange?

Health Exchanges: Three Key Sources

1. 1. 1.

Legislative Sponsors Governors Office Consumer Advocacy Organizations

Medicaid Expansion
The health reform law originally expanded Medicaid

eligibility to everyone under 133 percent of the Federal Poverty Line

$14,520 for a single person $58,040 for a family of 4

Then, the Supreme Court decision happened The Supreme Court ruled that states cannot lose the rest of their Medicaid funding for not participating in the expansion Translation: The Medicaid expansion is optional.

Medicaid: State of Play

Medicaid: Three Story Ideas

Is your state participating? Who are the interests

pushing in favor and against?

Cheat sheet: Hospitals and provider groups tend to like the Medicaid expansion.

The economic angle: How much money is on the

table?
The personal angle: Who are the people this

impacts? How does this effect them?

Medicaid: Three Key Sources

State Medicaid director 2. Public hospitals 3. Health committee legislators
1.

Prevention and Public Health

The health law is mostly known as an insurance

expansion. But there are billions of dollars being spent on prevention programs largely on local projects.

Communities Putting Prevention to Work Grants Public health infrastructure grants Workforce grants

Health Law Spending State of Play

Prevention & Public Health Three Story Ideas

How are Affordable Care Act dollars being spent in

your states and local communities?

Explanatory journalism can be powerful here

Are those programs working? Whats the evidence

suggest about whether they will or wont be successful? How do local interests feel about the new funds that have come into the state?

Prevention & Public Health - Examples

Prevention & Public Health Three Key Sources

Local health departments State department of health services Advocacy groups

Three Helpful Resources

The Center for Consumer Information and Insurance

Oversight: http://cciio.cms.gov

State Refor(u)m, a project of the National Academy

of State Health Policy: www.statereforum.org

The NCSL database KFF ACA Fund Tracker:

http://healthreform.kff.org/federal-fundstracker.aspx