What States Need to Know About IT and Medicaid Reform

August 29, 2011 By

Editor’s Note: John Petraborg is the client industry executive of HP Health and Human Services.

“This country cannot be strong if its people are sick and poor.”

This quote is attributed to President Teddy Roosevelt during his 1912 candidacy when advocating for universal health coverage for Americans. During the past century, several presidents — including Harry Truman, Richard Nixon and Bill Clinton — pushed for comprehensive health reform but failed. But history was made in March 2010 when Congress passed the U.S. Patient Protection & Affordable Care Act and the Health Care and Education Reconciliation Act, which were both signed by President Barack Obama.

Unlike past legislation enacted by Congress, the Affordable Care Act will touch the lives of virtually every single American regardless of age or economic status. The new federally enacted reform is projected to cost $940 billion over 10 years and add millions of people to public and private insurance programs. Medicaid agencies will be at the heart of making health reform a success.

Medicaid has always been categorical in nature — meaning that to qualify for coverage a person had to fit into a specific category, such as being a low-income child, pregnant or a disabled adult. This will change markedly with the implementation of health reform, broadly expanding Medicaid to virtually all Americans whose income is below 133 percent of the poverty level. Thus, health reform will affect many groups that aren’t now able to obtain or maintain coverage.

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