NACA Events at the NACo Annual Conference

Health Care Reform in 2018 and Beyond

BLOG POST | Aug 3, 2017
Idea Exchange at the The NaCo

The National Association of Counties (NACo) held its 2017 Annual Conference and Exposition in Franklin County/Columbus, Ohio, July 21 to 24. At the event, the National Association of County Administrators (NACA), an affiliate of ICMA, hosted its County Administrators’ Idea Exchange, where in an informal setting county officials from across the country discussed issues specifically relevant to counties. NACA also hosted an event sponsored by Cigna: Health Care Reform in 2018 and Beyond.

Here are some key takeaways from the Idea Exchange:

  • Medicaid cuts or state control of funds has complicated the funding of county-operated nursing homes, leading counties to consider releasing control of nursing homes to a third party.
  • Despite uncertainty around funding sources for grants, research has shown that counties tend to get about the same amount of funding from grants each fiscal year.
  • Maintaining election equipment has also created hard funding questions for counties. Some are waiting on state or federal funds while others are looking at partnering with nearby counties to reduce cost.
  • Population growth is usually a good thing for counties; however, it also presents such challenges as stress on existing infrastructure and makes planning for future projects more difficult, especially for projects that involve state assets like highways.
  • There is a misconception that recreational marijuana will be a boon to local economies. However, consumer counties do not see the benefits that grower counties do. 

NACA hosts three Idea Exchanges per year, in conjunction with its meetings at the NACo Annual and Legislative Conferences, and at the ICMA Annual Conference. Click here to learn more and access the archive of previous Idea Exchanges.

The session "Health Care Reform in 2018 and Beyond" was presented by Alisa Gifford, counsel for employment and benefits, Cigna Legal. Gifford is a subject matter expert on health care reform, and she demonstrated a command of the subject while presenting relevant, up-to-the-minute information on the reform process and fielding a multitude of questions from the engaged attendees. Beginning with an overview of the current health care environment, she then walked through the differences between the Affordable Care Act (ACA), the Better Care Reconciliation Act (BCRA), and the American Health Care Act (AHCA), and discussed these hot topics:

  • U.S. tax reform
  • Wellness rules
  • Employee coverage under the Employee Retirement Income Security Act (ERISA)
  • Prescription pricing
  • Paid leave
  • Nondiscrimination rule issued in May 2016.

Cigna, a Premier Level Strategic Partner of ICMA, provided links below to access more information and resources:

For information about NACA, click here or send an email to

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