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Ensuring Access to Care in Medicaid Under Health Reform

This paper examines the key issues raised in a December 2010 roundtable discussion of federal and state officials and experts convened by the Kaiser Commission on Medicaid and the Uninsured to examine important issues related to ensuring access to care in Medicaid under the Patient Protection and Affordable Care Act (ACA). The ACA expands Medicaid to reach millions of low-income uninsured Americans and, recognizing current serious access problems system-wide, takes significant steps to build capacity and help ensure that the new coverage translates into access to needed services.

The discussion identified key access gaps in access to care in Medicaid as well as strategies that could help to close them, including steps to more fully realize existing primary care capacity, approaches to increase provider participation in Medicaid, greater support for safety-net providers, and development of more coordinated and integrated service delivery systems. Participants also identified important issues as states consider extending managed care to newly eligible Medicaid adults. Finally, the discussion considered challenges related to coordination between Medicaid and the new health insurance Exchanges, a significant issue in light of ACA’s vision of a system with seamless coverage and care transitions for individuals and households whose circumstances change.

The discussion was the latest in an ongoing series of Health Reform Roundtables that explore key issues related to implementing the expansion of Medicaid under health reform.

Issue Brief (.pdf)