What is ACA -Affordable Care Act

The Affordable Care Act



The Affordable Care Act  provides Americans with better health security by putting in place comprehensive health insurance reforms that will:

  • expand coverage,
  • hold insurance companies accountable,
  • lower health care costs,
  • guarantee more choice, and
  • enhance the quality of care for all Americans. 

AFFORDABLE CARE ACT PROVISIONS

DESCRIPTION

Eligibility Fills in current gaps in coverage for the poorest Americans by creating a minimum Medicaid income eligibility level across the country.
Financing Beginning in 2014 coverage for the newly- eligible adults will be fully funded by the Federal Government for three years.  It will phase down to 90% by 2020.
Information Technology Systems and Data Policy and financing structure designed to provide states with tools needed to achieve the immediate and substantial investment in information technology systems that is needed in order to ensure that Medicaid systems will be in place in time for the January 1, 2014 launch date or the new Affordable Insurance Exchanges as well as the expansion of Medicaid eligibility.
Coordination with Affordable Insurance Exchanges This system enables individuals and families to apply for coverage using a single application and have their eligibility determined for all insurance affordability programs through one simple process.
Benefits People newly-eligible for Medicaid will receive a benchmark benefit or benchmark­ equivalent package that includes the minimum essential benefits provided in the Affordable Insurance Exchanges.
Community-Based Long-Term Services and Supports Includes a number of program and funding improvements to help ensure that people can receive long-term care services and support in their home or the community.
Quality of Care and Delivery Systems Improvements will be made in the quality or care and the manner in which that care is delivered simultaneously with reducing costs.
Prevention Promotes prevention, wellness and public health, and supports health promotion efforts at the local, state and federal levels.
Children’s Health Insurance Program (CHIP) Extends funding for the Children’s Health Insurance Program (CHIP) through FY 2015, and continues the authority for the program through 2019.
Dual Eligibles A new office will be created within the Centers for Medicare & Medicaid Services to coordinate care for individuals who are eligible for both Medicaid and Medicare ("dual eligibles" or Medicare-Medicaid enrollees)
Provider Payments States will receive 100 percent federal matching funds for the increase in payments.
Program Transparency Promotes transparency about Medicaid policies and programs including establishing meaningful opportunities for public involvement in the development of state and federal Medicaid waivers.
Program Integrity Includes numerous provisions designed to increase program integrity in Medicaid, including terminating providers from Medicaid that have been terminated in other programs, suspending Medicaid payments based on pending investigations or credible allegations of fraud, and preventing inappropriate payment or claims under Medicaid.