Under the Affordable Care Act (ACA), states must raise the Medicaid fees they pay for primary care services provided by family physicians, internists, pediatricians, and nurse practitioners and physician assistants to the level Medicare pays for those services.  The federal government will cover 100% of the increased payments which became effective January 1, 2013 and will continue through 2014.  The purpose of this section of the ACA was to increase the availability of primary care providers in anticipation of increased demand beginning in 2014 under Medicaid expansion.  On average, in 2012, the fees paid for Medicaid primary care services were about 58% of those paid by Medicare.  The increase will especially benefit individuals who are eligible for Medicare and Medicaid since primary care providers now will receive the full Medicare amount.  Additional information about the increased primary care service fees is available from the Kaiser Commission on Medicaid and the Uninsured.

Department of Health and Human Services (HHS) Secretary Kathleen Sebelius extended the deadline to December 14th for state officials to notify HHS that they will operate health insurance exchanges. The Affordable Care Act requires the federal government to run the private health insurance marketplaces in states that do not elect to create exchanges.

The Arc has joined over 50 national organizations to develop a technical assistance paper to help state advocates and state policy makers decide on the rehabilitative and habilitative benefits required by the Affordable Care Act (ACA). One important feature of the ACA is the requirement that all qualified health benefit plans include 10 categories of essential health benefits.  While all are important to people with disabilities, the inclusion of the category of rehabilitative and habilitative services and devices is of particular importance to people with intellectual and developmental disabilities.  Each state has a great deal of flexibility to create its essential benefit package. The states will choose a state benchmark plan and if that plan does not include services in each of the 10 category areas it must be changed and the necessary services added.  The Arc hopes that advocates will find this document, which represents a consensus among national disability groups, useful on the state level.