On April 28, the Center for Healthcare Research and Transformation released a brief examining state requirements and policy options under the national health care reform law.  The brief outlines what states must do by 2014, their options for addressing those needs, and other aspects of health reform that states do not need to implement but that will affect state budgets.  The authors assert that the two most critical aspects of the law that states must implement are the Medicaid expansion and creation of health exchanges.

From the report: 

The Patient Protection and Affordable Care Act of 2010 (ACA) requires the establishment of significant new state-level structures by the year 2014. This document summarizes major requirements and policy choices for states between now and 2014, and describes other components of the ACA that do not involve state implementation but have state budgetary impacts.

The two most significant ACA requirements for state implementation between now and 2014 are:

1. To establish health insurance exchanges for individuals and small businesses

2. To expand Medicaid coverage to cover all those up to 133 percent of the federal poverty level (138 percent with the five percent income disregard), regardless of categorical eligibility.

Full report: Guide to State Requirements and Policy Choices in the Affordable Care Act (PDF | 855.48 KB)

Center for Healthcare Research and Transformation.  (2011).  Guide to state requirements and policy choices in the affordable care act.