Affordable Care Act funding: An analysis of grant programs under health care reform

February 22, 2016

Black magnifying glass over a white piece of paper reading "Affordable Care Act (ACA)".As part of the Patient Protection and Affordable Care Act (ACA), which was signed into law on March 23, 2010, Congress appropriated funding to expand access to care, implement private insurance reforms, and enhance public health infrastructure. The ACA provided for both annual appropriations and multiple-year appropriations. Many ACA funds ended in fiscal year 2014 or 2015, including all market reform grants. However, several grants were extended for an additional year or more, including many of the maternal and child health programs. The ACA also includes a few permanent appropriations, including the Prevention and Public Health Fund (PPHF) and the Center for Medicare and Medicaid Innovation (CMMI).

Many ACA initiatives were funded through mandatory spending and do not require further Congressional approval. In total, the ACA included more than $100 billion in mandatory spending over a ten-year period (FY2010-FY2019). This included $65.2 billion to the Children’s Health Insurance Program (CHIP) between FY2014 and FY2017, and $10 billion to extend other funding programs, as required by subsequent legislation.

This issue brief updates a previous CHRT brief and examines how ACA grants were awarded to states and local organizations from the shortened FY2010 (March 23, 2010 to September 30, 2010) through the end of FY2015. This brief also contains specific analyses of ACA funding in Michigan.