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Transforming States’ Health and Human Services Programs While Implementing the ACA

Health

Anthony Eleftherion is a First Focus Intern Associate

From the moment the Affordable Care Act (ACA) passed in 2010, the countdown to the date of implementation – January 1, 2014 – began. In states nationwide, this has meant a flurry of activity for state health agencies and advocates alike, as they seek to establish systems to support the new health insurance marketplaces known as Exchanges.

Non-health advocates see great potential in the development of the Exchanges too. As my colleague, Megan Curran, noted in a past blog:

The ACA (in Section 1561) also envisions that – in addition to health care – this modern,
streamlined system will be able to use much of the same original data to provide families access
to a variety of human service programs, such as cash assistance, food stamps, child care assistance, and much more. Considering the fact that a family whose income qualifies them for Medicaid will very likely qualify for a host of other public supports, this is an unprecedented opportunity to reduce red tape for families and improve benefits access, while also reducing administrative costs.

While the efforts to integrate health and human services systems may not grab the headlines, work at the state level has been ongoing. In addition to the encouragement and financial assistance offered by the ACA, currently 6 states are attempting to transform their health and human services programs through the Work Support Strategies (WSS) Initiative. This is a multi-year project housed at the Urban Institute and funded by the Ford Foundation, with additional support from the Open Society Foundations, the Annie E. Casey Foundation, and the Kresge Foundation. It seeks to streamline the access and eligibility standards for several programs including Medicaid, Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF).

The recent discussion at the Urban Institute, (Transforming States’ Health and Human Services Programs While Implementing the ACA), involved panelists from both local and state health and human services departments and public policy firms addressed the benefits and challenges of states taking on these streamlining efforts under the simultaneously impending 2014 ACA deadline. Specifically, Alice Weiss, who represented the National Academy for State Health Policy (NASHP), acknowledged that while states are taking a risk in undertaking both tasks simultaneously, pairing the ACA’s requirements with the federal support for simplifying the provisions of services was certainly worth the risk.

Another benefit of supporting both initiatives that the panel discussed was the state’s ability to reduce the burden on their employees and administrative systems. By streamlining access to the various health and human services programs, states could assist their employees in dealing with the increased caseloads that will occur with the ACA – thereby ensuring families will continue to be served efficiently.

The need to streamline access and eligibility standards for programs such as Medicaid, SNAP and TANF is clearly of great importance to states and families alike. Streamlining these processes will promote greater efficiency in the programs benefitting children. Increasing efficiency will ensure that children are subject to fewer disruptions in access to their safety net and healthcare benefits. As a result, the states will incur less administrative costs for these benefit programs, potentially making greater funding available for the children and families in need.

Though challenges do exist with streamlining these processes and implementing the ACA simultaneously, the work supported by the WSS Initiative to date provides a promising model for improved service delivery for children and their families moving forward.

For More Information:

November 2012: Data Sharing in Public Benefit Programs – An Action Agenda for Removing Barriers by Cari DeSantis and Sarah Fass Hiatt for the Coalition for Access and Opportunity (First Focus, the Center for Law and Social Policy, and Single Stop USA)

October 2011: How Human Services Programs and Their Clients Can Benefit from National Health Reform Legislation by Stan Dorn for the Urban Institute and the Coalition for Access and Opportunity (First Focus, the Center for Law and Social Policy, and Single Stop USA)