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50 Ways to Implement Health Reform: State Challenges and Federal Assistance

Monday, August 02, 2010

As the second in a series to explore implementation of the Patient Protection and Affordable Care Act, this briefing provided an overview of how the states and the federal government are working together to implement various provisions of the new law. For example, while the law allows for flexibility in the way states set up exchanges, states will likely need technical assistance from the federal government to get the job done.

This session, sponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation, looked into the key challenges facing states, including working within state legislative cycles against tight deadlines in the federal law, creating new roles at the state level as state budgets are being squeezed, and others. It looked at both near-term provisions, such as high-risk pools, as well as other provisions farther down the road, such as setting up exchanges and instituting changes to Medicaid eligibility.

What challenges need to be overcome by the states to implement various provisions in the law? What can we learn from implementation of previous federal reforms such as the Balanced Budget Act (BBA) and the Health Insurance Portability and Accountability Act (HIPAA)? How are states managing new tasks while making job cutbacks in tough economic times? What are some of the various policymaking tools states are using to affect change in the business of health care? What are leading states doing right? What are some of the federal legislative and policymaking challenges ahead?

Panelists were: Jay Angoff, head of HHS’s Office of Consumer Information and Insurance Oversight; Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University; Brian Webb, manager for health policy and legislation at National Association of Insurance Commissioners (NAIC); and Lorez Meinhold, director of health reform implementation in Colorado. Sen. Jay Rockefeller moderated, assisted by Ed Howard of the Alliance.


 Ed Howard, Alliance for Health Reform, Moderator
 Sen. Jay Rockefeller, United States Senate, Moderator
 Jay Angoff, HHS Office of Consumer Information and Insurance Oversight, Speaker
 Len Nichols, George Mason University, Speaker
 Brian Webb, National Association of Insurance Commissioners, Speaker
 Lorez Meinhold, Office of the Governor of Colorado, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: 50 Ways to Implement Health Reform: State Challenges and Federal Assistance (Adobe Acrobat PDF), 8/2/2010
Event Summary: Event Summary (Word Document), 8/2/2010
Full Webcast/Podcast: 50 Ways to Implement Health Reform: State Challenges and Federal Assistance

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Lorez Meinhold's Powerpoint Presentation (PowerPoint), 8/2/2010
Brian Webb's Powerpoint Presentation (PowerPoint), 8/2/2010
Len Nichols PowerPoint Presentation (PowerPoint), 8/2/2010

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Event Summary (Word Document), Alliance for Health Reform, 8/2/2010
Agenda (Adobe Acrobat PDF), Alliance for Health Reform , 8/2/2010
Sourcelist (Adobe Acrobat PDF), Alliance for Health Reform , 8/2/2010
Materials List (Adobe Acrobat PDF), Alliance for Health Reform , 8/2/2010
Speaker Biographies (Adobe Acrobat PDF), Alliance for Health Reform, 8/2/2010

Offsite Materials (briefing documents saved on other websites)

Why the Health Reform Wars Have Only Just Begun (Adobe Acrobat PDF),The Heritage Foundation, 7/6/2010
Health Insurance Reform and the Tensions of Federalism, New England Journal of Medicine, 6/17/2010
HHS Secretary Sebelius Announces New Pre-Existing Condition Insurance Plan, U.S. Department of Health and Human Services,, 7/1/2010
Health Coverage for the High-Risk Uninsured: Policy Options for Design of the Temporary High-Risk Pool (Adobe Acrobat PDF),National Institute for Health Care Reform, 5/1/2010
What Is the Impact of the Patient Protection and Affordable Care Act (PPACA) on the States? (Adobe Acrobat PDF),Urban Institute, 6/1/2010
Health Insurance Exchanges Under the Affordable Care Act: Key Policy Issues, The Commonwealth Fund, 7/15/2010
Health Reform Implementation Timeline (Adobe Acrobat PDF),Kaiser Family Foundation, 6/15/2010
Behind the Scenes of Health Reform: The National Association of Insurance Commissioners, Kaiser Health News, 7/15/2010
State Policy Makers’ Priorities for Successful Implementation of Health Reform (Adobe Acrobat PDF),National Academy for State Health Policy, 5/1/2010
State Actions to Implement Federal Health Reform , National Conference of State Legislatures, 7/21/2010
Insurance Pools Readied in Some States, New York Times, 6/25/2010
States' responses to health law mixed,, 6/29/2010
Issues for State High-Risk Pools with Implementation of National Health Reform (Adobe Acrobat PDF),State Health Access Data Assistance Center , 6/1/2010
Enrollment in 2014: What’s at Stake for States? (Adobe Acrobat PDF),National Academy for State Health Policy, 6/14/2010
Implementing Insurance Market Reforms Under the Federal Health Reform Law, Health Affairs, 6/1/2010
Insurance Exchanges Under Health Reform: Six Design Issues for the States, Health Affairs, 6/1/2010


Sen. Jay Rockefeller of West Virginia discussed the importance of implementing the new health reform law wisely at the Aug. 2 briefing cosponsored by the Robert Wood Johnson Foundation. He is the Alliance for Health Reform founder. (12 min.)

Jay Angoff, director of the HHS Office of Consumer Information and Insurance Oversight, described how the federal government is working with states to implement health reform. From the Aug. 2 briefing cosponsored by the Robert Wood Johnson Foundation. (15 min.)

Len Nichols of George Mason University reviewed the many choices states have in how they implement health reform, at the Aug. 2 briefing cosponsored by the Robert Wood Johnson Foundation. (12 min.)

Brian Webb of the National Association of Insurance Commissioners discussed the important role that his group is playing in the implementation of the health reform law. From the Aug. 2 briefing cosponsored by the Robert Wood Johnson Foundation. (11 min.)


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