According to a USA Today-Kaiser Health News report, community health centers receiving federal funding will be closely scrutinized on quality and other performance indicators in the years ahead. Starting 2014, Federally Qualified Health Centers (FQHC) will start to see the first of $10 billion of funds appropriated by Congress in the health reform law.

With everything on the line, both sides gave their closing arguments for and against the law on Wednesday. Most notably, the justices questioned the parties regarding the expansion of Medicaid, projected to result in 16 million new insured Americans. With billions of new federal dollars being pumped into state programs to covered the newly eligibly at 133% of the federal poverty level, the states are claiming that this part of the Affordable Care Act unconstitutionally coerces them to expand a program against their prerogative.

Health reform offers the promise to develop a more modern approach to enrolling and retaining people in public programs. The traditional approach puts the onus mainly on the individual to “prove it to us that you are eligible, and keep on proving it to remain eligible.” This approach leads government to drop many people from Medicaid and CHIP who remain eligible, and large numbers remain uninsured for long periods of time.

In the ever renewing efforts to find ways to improve care, Kaiser News reports that leaders in Maryland have latched onto Health Enterprise Zones (HEZ) as a way to reduce disparities, particularly among minorities. Enterprise zones build on reduced taxes, targeted federal and state tax incentives and regulatory relief to encourage investment in hard-hit areas where access to care and other determinants of health are leading to less than ideal outcomes.

Now that the Supreme Court has agreed to take on the issue of the health reform law, the Medicaid expansion is shaping up to be as big of a fight as the individual mandate to buy insurance. The states, many led by Republican governors like Florida's Rick Scott, contend that the expansion of the government program for the poor and disabled is unconstitutional because it "coerces" states to participate. According to states like Florida that oppose the efforts, they want out of the requirements, but cannot opt out due to the law.

While the Supreme Court's decision to hear arguments against the individual mandate in health reform has received the vast majority of coverage, a decision regarding the expansion of Medicaid could have an even greater impact, according to The Washington Post..

As states prepare for bringing large numbers of people into Medicaid starting in 2014, it is important for them to have an accurate picture of the health conditions that are driving spending in this program. A recent presentation by Tricia McGinnis at the Center for Health Care Strategies in Princeton, NJ, offers some important guidance.

This blog post is by Chad Perman, a first-year master's student at the Maryland School of Public Policy who will be helping out with the "Making Health Care Reform Work" blog.

As the new fiscal year begins, about a dozen states are reducing the amount they reimburse Medicaid providers in an effort to reduce the strain the program is placing on their budgets, according to Kaiser Health News in collaboration with USA Today. The cuts must get federal approval. Many other states have reduced Medicaid reimbursement rates in recent years. It is one of the easiest tools states have to reduce their costs.

We've written a lot on this blog about the debate within several states about whether to create a state-run insurance exchange, with some conservatives believing that exchanges must be opposed just as health reform overall must be opposed. But that dispute seems to be dying down, with most states -- even those with staunch GOP governors -- moving forward.