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Report looks at status of ACA health coverage provisions by state

January 31, 2014

A new report from the Commonwealth Fund examines the status of state action on the Patient Protection and Affordable Care Act’s primary mechanisms for increasing access to health coverage: market reforms, health insurance marketplaces, and expansion of Medicaid eligibility to low-income adults. Only five states have failed to implement any of the three components, according to the report. ACA market reforms include expanded access to coverage for young adults, bans on preexisting condition exclusions and on lifetime limits for health coverage, coverage of a minimum set of essential health benefits, and other consumer protections. “Where states have been unable or unwilling to implement the Affordable Care Act, federal regulators have stepped in to directly enforce the market reforms and operate the marketplaces,” the report notes. “As a result, nearly all states are requiring or encouraging compliance with the market reforms, every state has a marketplace, and more than half of states expanded their Medicaid programs.…Yet, with no fed­eral backup in the 20 states that declined to expand their Medicaid programs, millions of low-income adults may continue to face barriers to meaningful coverage.”