Fact Sheet: The Maintenance of Effort (MOE) Provision in the Affordable Care Act

The Affordable Care Act (ACA) included a “maintenance of effort” (MOE) provision that has ensured stability of coverage for children in Medicaid and CHIP, even as the rest of the U.S. healthcare system has seen significant change. The MOE—along with coverage expansions for parents and other adults in Medicaid and the Marketplaces – has helped bring the uninsured rate for kids down to an historic low. Ninety-five percent (95%) of children have coverage today, and Medicaid and CHIP cover almost 36 million children nationwide.

Kelly Whitener is an Associate Professor of the Practice at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.
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