Timeline for ACA Implementation

January 1, 2014, represented an important date for states to begin insuring individuals through the health insurance marketplaces and expanded Medicaid, if they chose the option, and providing many of the patient protections and benefits offered through the ACA. Through 2014 and beyond, states—whether they have chosen to expand Medicaid or not and whether they have decided on a state-based, partnership, or federally-facilitated marketplace—could continue to face significant challenges in implementing new policies, procedures, and systems, as well as in maintaining and improving coverage for children and youth. The timeline below illustrates the major ACA provisions affecting children’s coverage and the following sections discuss some of the key challenges and concerns for children’s coverage as states implement the ACA.

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Key Implementation Issues for Children’s Coverage


The Toolbox for Advancing Children’s Coverage through Health Reform Implementation discusses states’ challenges and concerns for children’s coverage in four areas: