A Closer Look at ACA Opportunities for Special Populations

This week, we posted two documents that examine the impact of health reform on specific populations in two states. The needs of special populations have not yet received much attention; however, these needs are extremely important to consider as health reform implementation moves forward and states begin making decisions about enrollment strategies and benefit design issues. Other states may find these analyses useful as they move forward on implementation.
The report, Impact Arizona: Health Reform Hits Arizona released by St. Luke’s Health Initiatives, examines special populations and specific services, such as dual eligibles, Indian health, reproductive health, early childhood and family support, and behavioral health care services. For example, the authors highlight the ACA provisions that affect American Indians (pp. 88-94), many of which will be critical for states creating the exchange, planning the Medicaid expansion, and coordinating enrollment between the two programs, as well as all the other components of the law. One example is that tribal organizations are considered Express Lane Entities allowing for presumptive eligibility under Medicaid and CHIP. The Arizona report also takes a look at behavioral health issues in ACA and examines some of the specific opportunities presented in ACA and the decisions the state will need to make to expand coverage of behavioral health services (pp. 70-71) and address behavioral health workforce quality issues and provider shortages (pp. 71-72).
A brief prepared by Washington State focuses on opportunities in the ACA for meeting the chemical dependency needs of childless adults who will gain access to Medicaid in 2014. Althoughreports on this subject conflict, this childless adult population may have many chronic health needs, including chemical dependency. Health Care Reform, Medicaid Expansion and Access to Alcohol/Drug Treatment: Opportunities for Disability Prevention makes the case that many of the state’s newly eligible Medicaid enrollees really are likely to have drug and alcohol treatment needs. It contains calculations that determine the state will ultimately save money by providing drug and alcohol treatment services through Medicaid. Finally, the brief provides a short overview of steps that the state could take now to ensure that it has adequate drug and alcohol treatment capacity in 2014.
As always, send us your state-developed resources at statereforum@oldsite.nashp.org.