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VOLUME 49 | NUMBER 6.1 | DECEMBER 2014


The Need for State Health Services and Policy Research

Many provisions of the Affordable Care Act of 2010 (ACA) are being implemented at the state level, and state decisions will play a significant role in the successful implementation of the law. Effective evaluation of the ACA will depend on rigorous health services research conducted at the state level.

The Supreme Court decision of 2012 rejected the requirement that states must expand their Medicaid programs to include individuals with incomes up to 133 percent of the federal poverty level (FPL). This decision made the Medicaid expansion optional for states and guaranteed variability in ACA implementation. To date, 28 states including the District of Columbia are moving ahead with the Medicaid expansions, 21 states are not moving forward, and 2 states are considering the expansion option (The Henry J. Kaiser Family Foundation,Status 2014).

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