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In addition, as discussed below, ACA expands Medicaid eligibility (at state option) to all adults with incomes up to 138% of the federal poverty level. On the health care delivery front, changes include new ways to fund and deliver care (eg, moving away from the fee-for-service mechanism traditionally found in the U.S. health care system). The above ACA reforms support the goals of the National HIV/AIDS Strategy to reduce new HIV infections, increase access to care/improve outcomes, reduce disparities, and improve coordination of the nation's response to the U.S. HIV epidemic. Ryan White agencies and consumers can support ACA
Ryan White and ACA ACA has many implications for Ryan White programs. An
See this Kaiser chart on the status of Medicaid expansion and current eligibility levels in the states. See Medicaid.Gov for information on your state's Medicaid program. See this HIVMA fact sheet overview of new coverage options (Medicaid expansion, Marketplaces, key resources). Ryan White programs must conduct eligibility determinations and recertifications, in accordance with the Ryan White payer of last resort provision. See the HRSA policy guidances on Ryan White and Medicaid, which direct Ryan White grantees to vigorously pursue Medicaid enrollment and billing for Ryan White clients. Relatedly, see HRSA policy guidances on eligibility determinations and recertifications. See how Ryan White service categories can be used to
See how the individual mandate works in relation to income and affordability. Accessing Health Insurance: Marketplaces Marketplaces are where individuals and small businesses will shop for health insurance coverage from private insurers and from public insurers such as Medicaid. Here are some specifics: Each state has the option of deciding whether to operate its own state Marketplace, to partner with the federal government, or default to a federally facilitated
Learn more: Use this map-based site to see what's happening around the country with medical homes and patient-centered medical care. Changes in Financing
Learn more about Marketplaces from HealthCare.gov. Watch the What Is the Health Insurance Marketplace video. See the list of state Marketplaces and state partnership Marketplaces (with declaration letters, approvals, and links to state websites). See what states are doing at State Reforum. See this HIVMA fact sheet overview of new coverage options (Medicaid expansion, Marketplaces, key resources). Changes in Care Systems Reforms are under way to improve the health care infrastructure and develop new care delivery approaches that can improve quality and lower costs. New funding has gone toward expansion of the Health Centers program, administered by HRSA's Bureau of Primary Health Care. Prevention enhancements include, for example, little to no cost sharing for various preventive services. Also, new prevention initiatives have been funded under the Prevention and Public Health Fund. Regarding IT, under the Office
Under ACA, Marketplaces will offer individuals a number of coverage options through Medicaid (in states that expand eligibility) and private health insurance plans. As a result, an increasing proportion of HIV/AIDS care will be covered by these payers. In order to be well positioned to continue serving their clients--who will be making choices from among these options-Ryan White agencies need to enhance their third-party billing systems and establish new relationships with multiple provider networks and health insurance plans.