State of the States

Laying the Foundation for Health Reform

Despite fiscal constraints and the rising demand for public health programs, many states made early achievements in implementing the Affordable Care Act (ACA) in 2010, as documented in the new State of the States report from State Coverage Initiatives (SCI), a national program of the Robert Wood Johnson Foundation. The SCI report—Laying the Foundation for Health Reform—tells stories of how states:

  • Established committees and task forces to study its impact and develop strategic plans for responding to its provisions;
  • Implemented state-based pre-existing condition insurance plans;
  • Worked with insurance carriers and the public to implement insurance reforms included in the ACA;
  • Improved their premium rate review process and considering the impact of the medical loss ratio requirements;
  • Collected data and early planning for state-based health insurance exchanges;
  • Worked to cut costs and improve outreach and enrollment efforts in Medicaid and the Children’s Health Insurance Plan; and
  • Undertook efforts to improve the health care delivery system and promote public health.

The report concludes that while some states are still considering big questions related to their goals for health reform, many have begun to yield innovative and interesting results with much more to come over the next several years.