State Health Advocate To-Do List for 2013

February 14, 2013

2013 will be a busy year! Families USA pulled together some ideas about key issues you may want to tackle in your state this year. We know that you won’t have time to do everything on this list, but here’s a place to start. Topics include (click the link to jump to that section below):

Below find a quick summary of actions, and to get the full guide from Families USA, download it (PDF format) here.

Medicaid Expansion

  • „„Make your voice heard in the federal budget negotiations. The Medicaid expansion will only work if the program stays strong. Make sure that your members of Congress hear from you that Medicaid should not be cut as part of the budget negotiation process. See Families USA’s Medicaid Defense Center at for information on where we are in federal budget negotiations, talking points, and other tools to make the case to protect Medicaid

„„For advocates in states that haven’t made a firm commitment to expand Medicaid:

  • Keep pushing your state in that direction. Use your best campaign strategies to move the expansion forward. Contact Families USA’s Field department if you’d like help developing arguments, reviewing analyses, discussing messaging, developing story banking strategies, or connecting with advocates in other states to discuss strategies that work

„„For advocates in states expanding Medicaid

  • „„Get involved in your state’s Medicaid benefit plan selection. Medicaid has to include the essential health benefits but can include more. Identify the individuals who will be most involved in determining Medicaid benefits for the expansion population and meet with them. Build a coalition to advocate for comprehensive benefits appropriate for the Medicaid expansion population and make sure that the benefits comply with mental health parity requirements in the Affordable Care Act


  • Advocate for and share expertise on effective in-person outreach and assistance programs. Ensure that your state and/or the federal government know the best existing resources, such as community-based organizations and Consumer Assistance Programs, to build on in the development of the navigator program and in-person assistance programs. (It’s important to note that in-person assistance programs will only operate in state consumer assistance partnership exchanges and in statebased exchanges that choose to implement this program).
  • Work to ensure affordable coverage for the 100 percent to 400 percent of poverty population. If you are in a willing state, think about ways your state or charities can further help people with insurance and care costs

Medicaid, CHIP, and Exchange Eligibility and Enrollment

  • Create consumer-friendly, seamless eligibility and enrollment systems for Medicaid, CHIP, and exchange coverage
  • Make sure your state provides high-quality translations of the new application for health coverage for all the main languages spoken in your state.
  • Ask your state how it plans to integrate other public benefits into the process of applying for health coverage (through screenings or developing a new multi-benefit application), and how they will address increased volume of applications beginning in October 2013.

General Private Insurance Work (Outside of the Exchange, too)

  • Work with your state to pass individual and small group market laws that echo federal requirements on guaranteed issue and community rating and build in further protections.
  • Speak up about the importance of Affordable Care Act’s protections for people with pre-existing conditions and the need for fair premiums for people in less-than-perfect health.
  • Help to publicize Affordable Care Act reforms that will take place in 2014 and the October 2013 open enrollment period. Help to train community groups to answer consumers’ questions.

Dual Eligibles

  • If your state is pursuing a dual eligibles financial alignment demonstration, there are multiple stages of development where advocates can play a useful role. The Medicaid-Medicare Coordination Office (MMCO, the dual eligibles office) at CMS is very serious about making sure states have ongoing consumer input, and MMCO wants to hear directly from advocates as well.


  • Remind state policymakers that some people will still need a safety net in 2014, including the remaining uninsured, people who cannot afford deductibles or cost-sharing, and those who have uncovered medical expenses. Review nonprofit hospitals’ community benefits and financial assistance policies. Find out when the hospitals will be updating those policies and provide input about changing needs. Consider state laws about hospital financial assistance.


Get the full PDF of the to-do list in the link below.

This material was originally published by Families USA and is reprinted here with permission.





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