Implementing the Affordable Care Act

Thursday, July 28, 2016

It’s a work in progress—that’s how a new brief from the 40-state ACA Implementation Research Network, a project jointly operated by the Rockefeller Institute and the Brooking Institution, describes ACA implementation so far. Among the brief’s findings: Medicaid enrollments have exceeded early forecasts, as many people who had been eligible for Medicaid only learned of their eligibility when checking on the exchanges. It also discusses the emergence of new concerns for consumers as many health insurance companies try to reduce costs by narrowing their networks of providers and by offering more tightly defined HMO plans; ever-changing market conditions, such as withdrawals by certain insurance companies from participating in the exchanges and warnings of increased rates; and the complex sharing of responsibilities between states and the federal government. As the brief notes, there is still a lot to learn, and “new laws like this take a long time to play out.”

GFOA recommends that state and local government employers that sponsor group health plans implement a process for reviewing federal health-care benefit requirements at least quarterly to ensure that they are aware of any newly issued or soon-to-be issued regulations. This level of monitoring will allow plan sponsors to implement the most cost-effective approaches to ensuring compliance with the ACA while offering appropriate benefit levels and options to employees and retirees. GFOA’s Complying with the Affordable Care Act best practice provides tips on establishing the monitoring process, including staffing levels and expertise, employee communications, maintaining grandfathered status, complying with the requirements, and whether to segregate retiree health-care plans.