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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
  • Enhance the quality of care for all Americans

The Affordable Care Act actually refers to two separate pieces of legislation — the Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) — that, together expand Medicaid coverage to millions of low-income Americans and makes numerous improvements to both Medicaid and the Children’s Health Insurance Program (CHIP).

Federal Policy Guidance

The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing laws passed by Congress related to Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program. To implement these programs, CMS issues various forms of guidance to explain how laws will be implemented and what states and others need to do to comply. In addition to regulations, CMS issues sub-regulatory guidance to address policy issues as well as operational updates and technical clarifications of existing guidance.

Since the new law was enacted in March 2010, CMS has worked together with state partners to identify key implementation priorities and provide the guidance needed to prepare for the significant changes to Medicaid and CHIP took effect on January 1, 2014.  In particular, CMS has provided several forms of guidance and federal support for state efforts to develop new or upgrade existing eligibility systems.

In March 2012, CMS released two final rules defining the eligibility and enrollment policies needed to achieve a seamless system of coverage for individuals who became eligible for Medicaid in 2014, as well as eligibility and enrollment for the new Affordable Insurance Exchanges. The final rules establish the framework for States’ implementation of the eligibility expansion going forward.

To learn more about Medicaid coverage, please go to www.medicaid.gov.

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