Helping States Expand Medicaid Coverage Under the Deficit Reduction Act

From 2007 through 2009, the National Academy for State Health Policy (NASHP), in Washington, worked with states to identify opportunities to extend health coverage to more people because of changes in the federal Medicaid program.

Medicaid provides coverage for 55 million Americans. The Deficit Reduction Act of 2005 (signed into law in early 2006) made the largest set of structural changes to the Medicaid program since its enactment in 1965. Although the intent of the act was to reduce Medicaid costs, it granted states new options to expand coverage. However, because of the complexity of the Deficit Reduction Act and the Medicaid program, states required assistance in identifying opportunities to expand coverage.

Key Results

During the grant period, NASHP:

  • Worked with states to develop and promote new models for using Medicaid to expand and improve coverage by hosting two meetings with invited local and national policy leaders to brainstorm new ideas and models.
  • Created several forums for state officials to learn about Medicaid and coverage expansion opportunities, including two public meetings and two invitational meetings convened in conjunction with the organization’s annual conference, a listserve for state Medicaid officials to share lessons learned with one another and six Web seminars or webcasts describing Medicaid coverage expansions and improvements.
  • Led a series of five in-depth conference calls between high-level state officials from California and Pennsylvania, who were considering various health reform initiatives, and officials from Massachusetts, Maine and Vermont, who were in the midst of implementing comprehensive state health reform.
  • Organized a technical advisory group on health reform composed of leading state officials from six states (California, Colorado, Kansas, Louisiana, Maine and Utah) to meet with congressional staff charged with crafting elements of national health reform legislation.
  • Produced 35 issue briefs as well as two articles in the journal Health Affairs that described models for improving coverage through Medicaid.