Spotlight on Health Reform

The federal framework for health reform was established by the Patient Protection and Affordable Care Act (PPACA), frequently called the Affordable Care Act (ACA), but it is the states that have responsibility for implementing many of its provisions. RPCC' s Spotlight on Health Reform focuses on the approaches being taken by the District of Columbia, Maryland and Virginia to implement health reform and what that means for our region - DC, Montgomery and Prince George's counties in Maryland, and Northern Virginia's five health districts. For details about the federal legislation and its four major components - public coverage, private coverage, health care quality, and health promotion and disease prevention - see Health Reform Overview from the Georgia Health Policy Center or a Detailed Summary and Timeline from the Kaiser Family Foundation.


Health Reform Implementation in the Region

  • The District of Columbia opted for early implementation of Medicaid expansions, becoming the second jurisdiction in the country to offer coverage to all adult residents with incomes under 133% of the Federal Poverty Level (FPL) effective July 1, 2010. It has requested from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) a 1115 waiver that would allow DC to expand Medicaid coverage to individuals with incomes between 134% and 200% of FPL.
  • Both Virginia and the District of Columbia have opted to participate in the federal -Pre-existing Condition Insurance Plan (PCIP) which designed affordable health insurance for District residents unable to purchase health coverage in the commercial marketplace because of a pre-existing medical condition. Maryland has its own plan.


The Region's Health Reform Implementation Advisory Groups

The District of Columbia, Maryland, and Virginia have each established health reform advisory or coordinating councils to provide recommendation and suggest strategies for implementing federal local health their jurisdiction.

The District of Columbia Mayor's Health Reform Implementation Committee includes the Director of the Department of Health Care Finance; the Commissioner of the Department of Insurance, Securities and Banking; the Director of the Department of Human Services, and the Director of the Department of Health. Subcommittees include Consumer Outreach, Health Insurance Exchange, Insurance Regulations, Medicaid Expansions and Delivery System Reform. For information on public meetings, Click HERE. For information on the Committee, Click HERE.

Maryland's Health Care Reform Coordinating Council issued its final report to the Governor on January 10, 2011. For the Council’s final report to the Governor, Click HERE. The Council includes representation from the executive and legislative branches. It formed six workgroups: Exchange and Insurance Markets; Entry Into Coverage; Education and Outreach; Public Health, Safety Net and Special Populations; Health Care Workforce; and Healthcare Delivery Systems. For more information on Maryland's Health Care Reform Coordinating Council, Click HERE.

The Virginia Health Reform Initiative Advisory Council issued its final report to the Governor on December 20, 2010. For the Council’s final report to the Governor, Click HERE. The Advisory Council has task forces in six areas: Medicaid Reform, Insurance Market Reform, Delivery and Payment Reform, Capacity, Technology, and Purchasers Perspective. For additional information on the Advisory Council, Click HERE. For additional information on the impact of health reform in Virginia prepared by The Commonwealth Institute, Click HERE.