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Reforming Medicaid

The Affordable Care Act (ACA) significantly expanded eligibility for those covered by Medicaid.  As a result of the new law and the subsequent Supreme Court decision in National Federation of Independent Business v. Sebellius, the majority of states have opted to expand Medicaid to cover all non-Medicare eligible individuals with incomes up to 133 percent of the federal poverty level (FPL).  Several of those states have expanded Medicare while testing alternative delivery models (known as the "private option") under Section 1115 Demonstration Waivers.  The ARC will work to facilitate communication, strategies and information-sharing among federation organizations on issues relating to state implementation of the Medicaid provisions of ACA.

AMA Reforming Medicaid Campaign: A comprehensive state campaign focused on issues including but not limited to physician reimbursement and access to care, preventing mandatory participation requirements, Medicaid recovery audit contractors (RACs) and dual eligibles.

Your AMA has devoted signification resources to creating a campaign focused on preserving Medicaid budgets.  Below is a sampling of the state advocacy tools that exist related to this campaign.  Please contact Annalia Michelman, JD, Senior Legislative Attorney, with any questions.

Medicaid Expansion
Medicaid Delivery and Payment Reform

Guiding principles:  
Medicaid delivery and payment reform

Medicaid Recovery Audit Contractors (RACs)

Campaign resources

Issue brief:
Medicaid RAC

Chart:
Medicaid RAC program contacts by state 

Talking points:
State advocacy roadmap Medicaid RAC

Physician Reimbursement and Access to Care

Campaign resources

Chart:  
Medicaid payment parity   

Model bill:  
Medicaid payment parity

Summary of research:
Medicaid physician reimbursement

Talking points:  
Medicaid payment parity

Preventing Mandatory Participation Requirements