CHCS - Center for Health Care Strategies

Improving the quality and cost-effectiveness of publicly financed health care

Technical Assistance for State Health Reform Assistance Network

Start Date:
May 2011
Robert Wood Johnson Foundation

The Patient Protection and Affordable Care Act (ACA) will expand health insurance coverage to as many as 32 million people nationwide - reducing the number of uninsured people in America by more than half. Much of the success in expanding the number of Americans with health insurance coverage, however, will depend on states' ability to effectively implement ACA's coverage provisions. Through the State Health Reform Assistance Network (the State Network), the Robert Wood Johnson Foundation (RWJF) is investing in technical assistance to maximize coverage gains made possible by the ACA.  

As part of RWJF's State Network, CHCS will be providing intensive technical assistance to 10 states as they work to implement ACA's coverage provisions. The participating states are Alabama, Colorado, Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island, and Virginia. In addition to technical assistance, RWJF will also support consumer engagement and research and monitoring activities in the same 10 states through complementary programs.

CHCS' technical assistance will help these states pursue the below milestones to expand Medicaid to newly eligible populations:

  1. Establish Benefit Design - Compare current Medicaid benefits and delivery systems with benchmark options and essential health benefits to meet the new populations' expected needs.
  2. Contract with Plans and Providers - Develop contracts with plans and providers, resolve procurement and rate-setting issues, and establish successful relationships between exchange qualified plans and Medicaid.
  3. Collaborate between the Exchange and Medicaid - Establish Medicaid's role in the exchange structure, ensure smooth coverage transitions, and use combined purchasing leverage to ensure access to coordinated care.  
  4. Secure Federal and State Authority - Identify and develop necessary state regulatory authority and obtain federal authority (e.g., through a State Plan Amendment or Medicaid waiver).
  5. Build a Bridge to Expanded Coverage - Assess the opportunities associated with strengthening current Medicaid programs, including benefit package redesign, cost sharing and rate-setting options, and efforts to integrate care; and early expansion.

Technical assistance activities will include: (1) needs assessment/policy analysis; (2) direct technical assistance and connection to expert resources; (3) stakeholder engagement; and (4) assistance in applying for federal implementation grants. An important part of the State Network will be synthesizing and sharing best practices and lessons learned across states.

RWJF's State Network is based at the Woodrow Wilson School of Public and International Affairs at Princeton University. For more information about RWJF's efforts on health insurance coverage, visit


Copyright © 2014 Center for Health Care Strategies, Inc.
200 American Metro Blvd., Suite 119 Hamilton, NJ 08619
tel. 609 528 8400    fax. 609 586 3679