Health Reform: Medicaid Workgroup

The Health Reform Medicaid Workgroup worked to identify implementation steps necessary to expand Medicaid coverage, including coordination of eligibility and enrollment between Medicaid and the Health Benefits Exchange: exploring various state Medicaid options, including home and community based services; and examine funding options under the Elder Justice Act.

Report | Executive Summary | Presentation: Impact of Affordable Care Act on North Carolina
Craigan Gray, MD, JD, MBA
Director, Division of Medical Assistance
North Carolina Department of Health and Human Services
Steve Wegner, JD MD
President of NCCCN
AccessCare, Inc.
Project Director  Pam Silberman, JD, DrPH
President and CEO
North Carolina Institute of Medicine
Workgroup Overview

The Affordable Care Act (ACA) expands Medicaid to include all non-elderly adults with incomes no greater than 133% of the federal poverty level (approximately $29,327 for a family of four in 2010). The ACA also simplifies the application and recertification processes, increases payments to primary care physicians, and offers the states new coverage options. In addition, the ACA includes new options to expand home and community based services for frail elderly and people with disabilities who need help with activities of daily living. This workgroup will also consider provisions dealing with nursing homes and elder justice.

As part of this effort, the Medicaid Workgroup will work to:

  • Identify implementation steps for Medicaid expansion

  • Coordinate enrollment between Medicaid and the Exchange

  • Explore Medicaid state options to expand services, including but not limited to: prevention, home and community-based services

  • Examine funding opportunities for Elder Justice Act

Information about the Affordable Care Act

General information about health reform including presentations, a summary of funding opportunities, and helpful links is available here.

Workgroup Background

The overall goal of this effort is to identify the decisions the state must make in implementing health reform. The Advisory Group and workgroups also plan on identifying potential funding opportunities to ensure that we are aware of, and take advantage of, any potential funding opportunity that will help us improve population health, access to care, and health care quality. We want to build on North Carolina's existing strengths and ensure that the decisions made in implementing the federal legislation serve the best interests of the state as a whole.

The effort will be led by Lanier Cansler, Secretary of the NC Department of Health and Human Services, and Wayne Goodwin, Commissioner of the NC Department of Insurance. The new federal health reform legislation will have significant impact on the way that health care is delivered in North Carolina.

To help the state prepare for these changes, eight different workgroups are being established:PreventionSafety NetHealth Professional Workforce, Health Insurance Exchange and Insurance OversightMedicaidNew Models of CareQualityFraud and Abuse.

This planning effort will be led by an Overall Advisory Group that will help coordinate the work of each of these workgroups. Each workgroup will meet approximately one time per month from August 2010-August 2011 to review specific sections of the legislation and examine any new funding opportunities that are made available as part of this legislation.