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Webinar: Implementing Health Reform in the States

Tuesday, March 27, 2012

The health care overhaul law passed by Congress in 2010 sets out national goals and requirements. But many of the key decisions implementing the law are left to the states.

For example, states have a lot of leeway in how they set up health insurance exchanges, where uninsured individuals and small business will be able to buy coverage starting in 2014. But only 15 states have actually passed legislation establishing an exchange, or have a governor who has set one in motion by executive order. Florida and Louisiana have said they will refuse to set up exchanges, meaning the federal government will organize exchanges in those states. On the other end of the spectrum, states such as Vermont and Oregon are working to change their health care systems in ways that go beyond the Patient Protection and Affordable Care Act.

The law provides for Medicaid expansions that will bring an estimated 16 million additional Americans under the Medicaid umbrella. But will states aggressively promote the program to these newly eligible individuals? What if the Supreme Court rules that the Medicaid expansion is unconstitutional?

This webinar offered an update on what’s happening in the states with implementation of the Patient Protection and Affordable Care Act. By watching the archived webcast of this event, you will be better able to answer questions on this topic for readers, viewers and listeners. Cosponsored by the Robert Wood Johnson Foundation and the Association of Health Care Journalists. 

Speakers were:

Enrique Martinez-Vidal ( is vice president for state policy and technical assistance at AcademyHealth. He is also the director of State Coverage Initiatives, a national program of the Robert Wood Johnson Foundation.

Matt Salo ( is executive director of the National Association of Medicaid Directors.  

Noam Levey ( covers health care policy for the Los Angeles Times/Tribune Washington bureau, which distributes his reporting to the Times and other Tribune newspapers, including the Chicago Tribune, Baltimore Sun and Harford Courant.


Ed Howard ( is the founding executive vice president of the Alliance for Health Reform, a nonpartisan, nonprofit health policy group in Washington, D.C. that he formed in 1991 with Sen. Jay Rockefeller (D-W.Va.)

The Alliance thanks the Kaiser Family Foundation for the use
of their television studio for this webinar.


Ed Howard, Alliance for Health Reform, Moderator
Enrique Martinez-Vidal, AcademyHealth, Speaker
Matt Salo, National Association of Medicaid Directors, Speaker
Noam Levey, Los Angeles Times, Speaker

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Briefing transcript (Adobe Acrobat PDF), 3/27/2012
Full Webcast/Podcast: Webinar: Implementing Health Reform in the States

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Source Materials

Materials List (Adobe Acrobat PDF), , 3/27/2012
Selected Experts List (Adobe Acrobat PDF), , 3/27/2012

Offsite Materials (briefing documents saved on other websites)

Obama health care law has unexpected beneficiaries, Associated Press, 11/3/2011
- Alonso-Zaldivar, Ricardo
State Progress Toward Health Reform Implementation: Slower Moving States Have Much to Gain (Adobe Acrobat PDF),Robert Wood Johnson Foundation, Urban Institute, 1/1/2012
- Blavin, Fredric, et al.
Despite skepticism, consultant's savings report gives shot in the arm to Oregon health care reforms, The Oregonian, 1/10/2012
- Budnick, Nick
High-Risk Pools -- Merely a Stopgap Reform, The New England Journal of Medicine, 5/12/2011
- Blumberg, Linda J.
Washington State Senate Democrats Unveil Reform Ideas They Say Will Save State Millions, KEPR TV, 1/12/2012
- La Corte, Rachel
Washington ruling could mean $145 million rebate to Floridians for health insurance, Miami Herald, 1/19/2012
- Dorschner, John
Both Sides Eager to Take Birth Control Coverage Issues to Voters, New York Times, 2/15/2012
- Eckholm, Erik
What we give up for health care, New York Times, 1/21/2012
- Emanuel, Ezekiel J
The End of Health Insurance Companies, New York Times, 1/30/2012
- Emanuel, Ezekiel and Liebman, Jeffrey
Establishing health insurance exchanges: A national overview of state efforts (Adobe Acrobat PDF),Kaiser Family Foundation, 1/1/2012
The Hot Spotters: Can we lower medical costs by giving the neediest patients better care?, The New Yorker, 1/24/2011
- Gawande, Atul
Birth control as election issue? Why?, Washington Post, 2/20/2012
- Gerhart, Ann
State Choices on Essential Benefits May Become More Complicated, California Healthline, 2/8/2012
- Gorn, David
A State Lawmaker's Guide to Health Insurance Exchanges, The Heritage Foundation, 3/21/2011
- Haislmaier, Edmund F.
Is the Pre-Existing Condition Insurance Plan Working?, The Commonwealth Fund, 11/22/2011
- Hall, Jean P.
Implementing Reform: Funding And Flexibility For States On Exchanges, Health Affairs Blog, 11/30/2011
- Jost, Timothy
Health reform: What we can learn from Pennsylvania , Washington Post, 8/24/2011
- Kliff, Sarah
The States' Next Challenge — Securing Primary Care for Expanded Medicaid Populations, New England Journal of Medicine, 2/10/2011
- Ku, Leighton, Karen Jones, Peter Shin, Brian Bruen, and Katherine Hayes
State Perspectives On Implementing Insurance Exchanges, Health Affairs Blog, 9/20/2011
- Lieberman, Steve and Drobac, Krista
Meet the Bay State’s Uninsured, Columbia Journalism Review, 9/26/2011
- Lieberman, Trudy
Kaiser: Florida readies its own health insurance exchange, leaves out help for low-income people, Florida Independent, 10/11/2011
- Lopez, Ashley
Rural state hospitals want Obama to nix healthcare law's special deal for Massachusetts, HealthWatch, 1/20/2012
- Pecquet, Julian
Regulating the Medical Loss Ratio: Implications for the Individual Market, Robert Wood Johnson Foundation, 4/1/2011
Equalizing Payments for Medical Care, New York Times, 11/11/2011
- Reinhardt, Uwe
The Options for Payment Reform in U.S. Health Care, New York Times, 2/17/2012
- Reinhardt, Uwe
State by State Enrollment in the Pre-Existing Condition Insurance Plan, as of August 31, 2011,, 10/1/2011
State Oversight of Premium Rates, United States Government Accountability Office, 7/1/2011
States receive more flexibility, resources to implement Affordable Insurance Exchanges, U.S. Department of Health and Human Services, 11/29/2011
Summary of New Health Reform Law (Adobe Acrobat PDF),Kaiser Family Foundation, 4/15/2011
State Health IT Job Market Looks Healthy, Information Week Healthcare, 11/13/2011
- Versel, Neil
Study: Vermont’s Universal Health System Will Significantly Slow Health Care Spending, FDL Action, 11/2/2011
- Walker, Jon
Implementing Health Reform: A Final Rule On Health Insurance Exchanges, Health Affairs, 3/13/2012
- Timothy Jost
Health care reform: States may test HHS power, Politico, 3/12/2012
- J. Lester Feder
Implementing the Affordable Care Act: State Action on Early Market Reforms (Adobe Acrobat PDF),The Commonwealth Fund, 3/1/2012
- Katie Keith, Kevin W. Lucia, and Sabrina Corlette
A Mid-Year State Medicaid Budget Update for FY 2012 and A Look Forward to FY 2013 (Adobe Acrobat PDF),The Kaiser Family Foundation, 2/1/2012


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