Capitol Research

Interstate compacts are contracts between two or more states creating an agreement on a variety of issues, such as specific policy challenges, regulatory matters and boundary settlements. This brief provides background on the history of compacts, their primary purposes, and information about compacts affiliated with the National Center for Interstate Compacts.

Medicaid matching rates to states before, during and after Recovery Act funding are analyzed. For every dollar a state spends for Medicaid, the average state gained $1.07 additional match for each state dollar spent under the Recovery Act enhanced rates. 

CSG's brief on State Health Insurance Exchanges describes the decisions states need to make in 2011 and 2012 to prepare for the exchanges to open in late 2013. Also read about what health insurance exchanges can accomplish and how state Medicaid programs will be involved.

CSG also hosted four regional webinars this month featuring Joel Ario, the Department of Health and Human Services official in charge of implementing the health insurance exchange provisions of the Affordable Care Act. Ario said the federal government is responsible for all necessary expenses states will incur between now and 2015 as they move to implement exchanges.

February Health Policy e-monthly readers linked most often to this story, as well as how states are avoiding Medicaid costs by keeping seniors in their communities rather than nursing homes:

  • Kaiser Family Foundation report on promising practices in several states
  • Federal government funding to 42 states to build community alternatives.

The Affordable Care Act mandates that states operate insurance exchanges to enable every citizen across the country to purchase or renew health insurance. The reform legislation provides federal support for “necessary” expenses so states can plan, establish and operate the exchanges for the first year of 2014. Although it specifies several conditions that insurance products offered through the exchange must meet, it allows the states great flexibility in determining how they will regulate and how much reform they will introduce for their state insurance market. Read about what health insurance exchanges can accomplish, how state Medicaid programs will be involved and what decisions states are facing in 2011 and 2012 related to health insurance exchanges.

While not a new concept in the public policy lexicon, transit-oriented development is receiving renewed attention as some states and communities ponder a future that may include high-speed rail. States have a vested interest in ensuring that huge investments in rail and transit systems pay off not only in improving transportation but also in creating economic development and helping to bring about healthier, more environmentally friendly and sustainable communities around transit stations. Fortunately, a number of states already have years of experience in using public policy to shape how this development takes place.