Navigating Health Reform
| HHS Launches Rebuilt Health Care Website Today, HHS launched the newly rebuilt HealthCare.gov website, where Americans will be able to get the information they need for open enrollment in October. Consumers now have the opportunity to sign up for emails and text messages, which will provide them with more information to help them make well-informed decisions when the time to enroll for coverage begins. And come October, individuals and small businesses will be able to buy insurance from qualified private health plans and check if they are eligible for financial assistance ? all in one place. The website will help you prepare for the coming insurance Marketplace, learn about the law, and more. http://www.healthcare.gov/ |
| Analysis: Health Exchanges And The Litigation Landscape by Stuart Taylor, Jr. Kaiser Health News. If you think that the Affordable Care Act has surmounted all of the major legal attacks its opponents could come up with, think again. Critics of the federal health law have only begun to fight, although most of their battles are decidedly uphill. The pending challenges to the law, and related regulations, range from the Goldwater Institute's claim that it gives the Independent Payment Advisory Board unconstitutionally broad powers over Medicare services and payments, to the more than 35 lawsuits by religious employers attacking a Department of Health and Human Services rule that requires them to provide their employees with insurance that covers women's contraceptives without a copayment. By far the broadest and potentially most damaging of the legal challenges turns on whether Congress intended that tax credits and subsidies to help consumers buy health insurance be available only through state-created exchanges. Many states are signaling that they may not create their own exchanges, leaving the federal government to do so, as the law requires. http://www.kaiserhealthnews.org/Stories/2012/November/29/health-law--litigation-and-exchanges.aspx |
| The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. These decisions will have enormous consequences for health coverage for the low-income population. This analysis uses the Urban Institute's Health Insurance Policy Simulation Model (HIPSM) to provide national as well as state-by-state estimates of the impact of ACA on federal and state Medicaid costs, Medicaid enrollment, and the number of uninsured. The analysis shows that the impact of the ACA Medicaid expansion will vary across states based on current coverage levels and the number of uninsured. This analysis shows that by implementing the Medicaid expansion with other provisions of the ACA, states could significantly reduce the number of uninsured. Overall state costs of implementing the Medicaid expansion would be modest compared to increases in federal funds, and some states are likely to see small net budget savings. The Kaiser Commission on Medicaid and the Uninsured. http://www.kff.org/medicaid/8384.cfm |
| Obama administration moves forward to implement health care law, ban discrimination against people with pre-existing conditions The Obama administration moved forward today to implement provisions in the health care law that would make it illegal for insurance companies to discriminate against people with pre-existing conditions. The provisions of the Affordable Care Act also would make it easier for consumers to compare health plans and employers to promote and encourage employee wellness. "The Affordable Care Act is building a health insurance market that works for consumers," said Health and Human Services Secretary Kathleen Sebelius. "Thanks to the health care law, no one will be discriminated against because of a pre-existing condition." "The Affordable Care Act recognizes that well-run, equitable workplace wellness programs allow workers to access services that can help them and their families lead healthier lives," said Secretary of Labor Hilda L. Solis. "Employers, too, can benefit from reduced costs associated with a healthier workforce." http://www.hhs.gov/news/press/2012pres/11/20121120a.html |
| GAO report identifies shortage in Medicaid providers Medicaid enrollment has grown significantly in recent years and is expected to continue growing as the Affordable Care Act (ACA) potentially extends Medicaid eligibility in 2014 to millions of uninsured Americans. A new Government Accountability Office (GAO) report examines (1) states' experiences processing Medicaid applications, (2) states' changes to beneficiary services and provider payment rates, (3) the challenges states report to ensure sufficient provider participation, and (4) the extent to which Medicaid beneficiaries reported difficulties obtaining medical care. http://www.healthreformgps.org/ |
| HHS Extends ObamaCare Health Insurance Exchange Deadline For States By Peter Suderman; Nov 16, 2012. Facing pressure from Republican governors, the Obama administration has officially pushed back the deadline for state governments to declare whether or not they're setting up ObamaCare's health insurance exchanges, reports CBS News. States were supposed to tell the Department of Health and Human Services whether they would create the exchanges by today, but now they have until December 14 to declare their intentions. They can also wait until February to decide whether they want to set up an exchange in partnership with the federal government. http://reason.com/blog/2012/11/16/hhs-extends-obamacare-health-insurance-e |
| More Health-Law Changes Coming in 2013 By Avery Johnson; The Wall Street Journal, October 21, 2012. Health-care reform is here to stay?for the foreseeable future. So for the millions of Americans with health insurance at their workplaces, this fall's "open enrollment" period will be one of the most important in years. Next year will see some of the many significant changes brought on by the Affordable Care Act, including easy-to-read plan summaries and caps on flexible spending accounts. The ability of health insurers to place limits on annual spending is also on its way out, while earlier reforms such as adding adult children to their parents' plans offer new options to consumers. Most of the really big changes-including health-insurance exchanges and tax credits to help people buy coverage-aren't coming into play until 2014. Still, the provisions going into effect in 2013, along with those that have already been introduced, can affect any changes you might want to make to your health coverage. And the presidential election is unlikely to change the landscape for people picking health plans this fall. If President Obama is re-elected, the changes stay. If GOP candidate Mitt Romney wins, getting rid of the law is unlikely to be a quick or easy process, given that the Democrats are expected to retain control of the Senate. http://online.wsj.com/article/SB10000872396390443854204578058753458394278.html?KEYWORDS=health+reform |
| Lawsuits Targeting Birth Control Rule Mount By David Pittman, Washington Correspondent, MedPage Today, Oct 15, 2012 Opponents of the Affordable Care Act's contraceptive coverage mandate have filed a total of 35 lawsuits against it so far, and they're hoping that at least one will result in the mandate being overturned. The mandate, which took effect Aug. 1, says all new insurance policies must provide birth control with no copayment. The requirement has riled political conservatives who say it encroaches on their religious freedom by forcing some faith-based employers to provide contraceptive coverage against their will. "Private decisions that should be made between families and doctors and their patients are now being controlled by bureaucrats in Washington, D.C.," Dominique Ludvigson, research fellow at the Heritage Foundation, in Washington, told MedPage Today. Churches themselves were exempt from the original rule, but most hospitals, universities, and other organizations with religious affiliations were not, although they were given an extra year to figure out how they could implement the policy. http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/35331 |
| A Citizens' Solutions Guide: Health Care Public Agenda's Citizens' Solutions Guides are nonpartisan, unbiased resources to help you think through a difficult issue in alternative ways, weighing and evaluating values, priorities, pros, cons and tradeoffs. The Guides can also be used as discussion starters for community and group conversations and in classes. Note that the Citizens' Solutions Guides are meant to help people start thinking and talking about an issue in productive ways - they are not meant to rigidly restrict thinking or dialogue. This document provides information about where things stand, lists some facts to consider, and presents three approaches with a list of resources. The perspectives described are not the only ways of dealing with the problem, nor are the viewpoints mutually exclusive in every respect. You can mix and match from different perspectives, or add additional related ideas. http://www.publicagenda.org/files/pdf/PublicAgenda_CitizensSolutionsGuide_Healthcare.pdf |
| Essential Health Benefits The Affordable Care Act ensures Americans have access to quality, affordable health insurance. To achieve this goal, the law ensures health plans offered in the individual and small group markets, both inside and outside of the Affordable Insurance Exchanges (Exchanges), offer a comprehensive package of items and services, known as "essential health benefits." Essential health benefits must include items and services within at least the following 10 categories: (1) Ambulatory patient services; (2) Emergency services; (3) Hospitalization; (4) Maternity and newborn care; (5) Mental health and substance use disorder services, including behavioral health treatment; (6) Prescription drugs; (7) Rehabilitative and habilitative services and devices; (8) Laboratory services; (9) Preventive and wellness services and chronic disease management: and, (10) Pediatric services, including oral and vision care. http://www.healthcare.gov/news/factsheets/2011/12/essential-health-benefits12162011a.html |
| Measuring Financial Vulnerability From Spending on Medical Care Rapidly growing medical care costs are increasingly competing for families' financial resources, particularly among middle- and low-income families. The recently implemented Supplemental Poverty Measure, which accounts for out-of-pocket medical care costs in the calculation of disposable income, showed that if it were not for the costs of premiums and other medical expenses not covered by health insurance, 10 million fewer people would have fallen under the poverty line in 2010. http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=09272012 |
| How Small Business Owners Get Health Insurance As with any economic policy issue, there has been much discussion of how the Affordable Care Act (ACA) will affect small businesses. But, there's been very little focus on how the health reform law will affect the owners of those businesses as people. As our recently released Employer Health Benefits Survey shows, small businesses are much less likely than larger businesses to offer health benefits to their workers. Half of businesses with 3-9 workers and 73% of firms with 10-24 workers provide health insurance. That contrasts with 98% of firms with 200 or more workers that offer health coverage. The workers in these firms that do not offer coverage must rely on employer-based insurance through a family member, buying insurance in the individual market (assuming they can afford the coverage and do not have a pre-existing health condition), or in many cases going uninsured. More information at: http://healthreform.kff.org/en/notes-on-health-insurance-and-reform/2012/september/how-small-business-owners-get-health-insurance.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NotesOnHL+%28Notes+on+Health+Insurance+and+Reform+%28Headlines%29+-+Kaiser%27s+Health+Reform+Source%29 |
| How the ACA Can Help the Homeless By Drew Altman, Ph.D., President and CEO, Kaiser Family Foundation. Estimates are that there are approximately 630,000 people who are homeless on any given night in the U.S. -- about two-thirds in shelters and one-third on the street or without real shelter. Several million people are estimated to experience homelessness over the course of a year. About two-thirds are individuals and the balance are in families. Providing better health coverage can help connect the homeless to needed health services. That is important not only to relieve suffering, but because untreated medical and mental health problems are significant contributing factors to unemployment and homelessness. Increased Medicaid coverage can also relieve burdens on safety net clinics and hospitals who serve the uninsured homeless now. But the biggest payoff will come if the availability of health coverage under the ACA also provides a new outreach opportunity that serves as a gateway to housing, employment, and other services state and local agencies and community organizations use to help the homeless get back on their feet. Just as importantly, this new effort could bring renewed attention at the state and local level to the problem of homelessness itself. http://www.kff.org/pullingittogether/altman_aca_help_homeless.cfm |
| Health care law increases number of mental and behavioral health providers Health and Human Services (HHS) Secretary Kathleen Sebelius has announced a new program, made possible by the Affordable Care Act, which will boost the number of social workers and psychologists who work with Americans in rural areas, military personnel, veterans, and their families. Through the Mental and Behavioral Health Education and Training grant program, $9.8 million is being awarded to 24 graduate social work and psychology schools and programs for three-year grants. The grants will help eligible institutions of higher education - including accredited schools of social work and psychology and accredited psychology internship programs - to recruit students and provide support for clinical training in mental and behavioral health. http://www.hhs.gov/news/press/2012pres/09/20120925a.html |
| Health care law ensures consumers get clear, consistent information about health coverage Because of the health care law, millions of Americans will have access to standardized, easy-to-understand information about health plan benefits and coverage. Insurance companies and employers are now required to provide consumers in the private health insurance market with a brief summary of what a health insurance policy or employer plan covers, called a Summary of Benefits and Coverage (SBC). Additionally, consumers will have access to a Uniform Glossary that defines insurance and medical terms in standard, consumer-friendly terms. http://www.hhs.gov/news/press/2012pres/09/20120924a.html |
| Health care law's impact on businesses varies By Kelly Kennedy, USA TODAY, September 23, 2012. Companies specializing in driving down spending on health care, whether through electronic records, preventive care or consolidating services, are turning out to be the biggest winners from the 2010 health care law. Investors, analysts and policymakers say any business that can help health care providers cut costs or keep patients from being readmitted to the hospital soon after an in-patient visit is attracting more customers and seeing more investment. Health care information technology spending for the second quarter hit $293 million, up from $86 million for the same period last year, according to Mercom Capital Group, a market research group that looks at health care technology. Those deals included telehealth technology, as well as mobile devices that providers carry to keep tabs on patient data. http://www.usatoday.com/money/story/2012/09/23/health-care-laws-impact-on-businesses-varies/57834596/1 |
| How the ACA Changes Pathways to Insurance Coverage for People with HIV There are multiple sources of insurance coverage and care for people with HIV in the United States. These include public programs, such as Medicaid and Medicare, and the Ryan White HIV/AIDS program, as well as private coverage through an employer or in the individual market. Medicaid, the nation's principal safety-net health insurance program for low-income Americans, is estimated to cover the largest share of people with HIV. Fewer are covered by Medicare, the federal health insurance program for people age 65 and older and younger adults with permanent disabilities, or have private insurance, and a significant share is uninsured, relying primarily on Ryan White, the nation's single largest federal grant program designed specifically for people with HIV who are uninsured or underinsured, and operating as the "payer of last resort." Eligibility for these different coverage sources depends on numerous factors, including state of residence, income, employment and health status, age, and citizenship. As a result, the current system of coverage for people with HIV is a complex patchwork that leaves some outside the system and presents others with barriers to needed access. http://healthreform.kff.org/notes-on-health-insurance-and-reform/2012/september/how-the-aca-changes-pathways-to-insurance-coverage-for-people-with-hiv.aspx |
| The Affordable Care Act Helps Rural America The Affordable Care Act gives hard-working families the security they deserve. The new health care law forces insurance companies to play by the rules, prohibiting them from dropping your coverage if you get sick, billing you into bankruptcy because of an annual or lifetime limit, or, soon, discriminating against anyone with a pre-existing condition. And it includes substantial new benefits and freedoms for rural America. Americans in rural communities face unique challenges when it comes to getting the health care they need: (1) Rural Americans have - on average - higher rates of chronic conditions, including diabetes, heart disease, and high blood pressure; (2) Rural communities face a shortage of primary care doctors and nurses; One fourth of America's population lives in rural areas, but only ten percent of physicians practice there; (3) Many rural residents have trouble affording health insurance, which is why rural communities have some of the highest rates of uninsurance in the country. http://www.whitehouse.gov/sites/default/files/docs/the_aca_helps_rural_america.pdf |
| Insurance Coverage Improves In 20 States, Census Shows Kaiser Health News, September 20, 2012. The percentage of people without health insurance fell in 20 states last year with Oregon, Rhode Island and Vermont seeing the biggest declines, according to an analysis of data released Thursday by the Census Bureau. Two states had a statistically significant increase in the uninsured rate, Missouri and Montana. Missouri's uninsured rate jumped from 13.2 percent in 2010 to 13.7 percent last year, and Montana's rate went from 17.3 percent up to 18.3 percent, according to the analysis by the University of Minnesota's State Health Access Data Assistance Center. http://capsules.kaiserhealthnews.org/index.php/2012/09/insurance-coverage-improves-in-20-states-census-shows/ |
| CBO: Health care penalty to hit 6M people USA Today, September 19, 2012. The Congressional Budget Office estimated today that nearly 6 million people will have to pay a penalty for not obtaining health insurance once President Obama's health care law is full in place. That's a 2 million increase over a previous estimate. The average penalty is estimated at nearly $1,200. The requirement that nearly all Americans buy some form of health insurance goes into effect starting in 2014. The Supreme Court upheld the so-called individual mandate in June. When fully implemented in 2016, the penalty is expected to raise $6.9 billion, the CBO estimated. http://content.usatoday.com/communities/theoval/post/2012/09/19/cbo-health-care-penalty-to-hit-6m-people/70000720/1#.UFtLSK7Avic |
| What Rural Needs to Know About the New Medicare I love my digital video recorder, during election season more than ever. It is great to record favorite shows for watching whenever you want to. And it preserves my aging sanity to be able to click forward over the endless televised political tantrums. Like many of us in Wisconsin, I'm tired of the endless candidate robocalls. Call me stupid, but I really don't think that Republicans will send granny (my wife) over the cliff or that the Democrats will put her before a "death panel." This may be an election in which we get to pick our poison: health care run by big government or by big business. The real differences between the parties are significant. But both share the reality that Medicare is going broke and needs to be reformed. The question is how to do it? http://www.dailyyonder.com/what-rural-needs-know-about-new-medicare/2012/09/11/4420 |
| Coverage of Colonoscopies Under the Affordable Care Act's Prevention Benefit The Affordable Care Act (ACA) requires private health insurers to cover recommended preventive services such as colonoscopies without any patient cost-sharing. This report finds that confusion over whether colon cancer screenings are preventive care or treatment means patients sometimes receive unexpected bills for the procedure. The report examines cost-sharing practices for colorectal screenings through interviews with experts and officials in the medical and insurance industries. This report was co-authored by The Kaiser Family Foundation, American Cancer Society, and National Colorectal Cancer Roundtable. http://www.kff.org/healthreform/8351.cfm |
| Obama Health Law Could Effect Hospitals' Nonprofit Status By extending health insurance to millions more people, the Affordable Care Act could make it harder for nonprofit hospitals to maintain their tax exemptions, says Forbes. Hospitals in many states already face public and political pressure over the amount of free and discounted treatment they provide, a key factor in regulatory proceedings to determine if they offer sufficient community benefit to justify their tax breaks. With far fewer uninsured people, the amount of charity care hospitals provide is likely to fall further, potentially making it harder for them to maintain nonprofit status, Forbes notes. The article cites two options for dealing with the issue: a wave of conversions to for-profit status or broader community-benefit standards that take into account services other than free care for uninsured patients. http://philanthropy.com/blogs/philanthropytoday/obama-health-law-could-effect-hospitals-nonprofit-status/53950?cid=pt&utm_source=pt&utm_medium=en |
| Updated Fact Sheet: The Medicaid Program at a Glance The Foundation's KCMU has updated a fact sheet that provides a concise overview of the Medicaid program, the populations that it serves, the services that it covers and the expanded role it will play under the Affordable Care Act. Medicaid covers more than 60 million low-income individuals and is financed jointly by states and the federal government. About half of all Medicaid enrollees are children. Non-elderly adults - mostly working parents - make up another quarter, while seniors and people with disabilities account for the rest. In 2009, Medicaid spending for services totaled $367 billion, about two-thirds of which was attributable to elderly and disabled beneficiaries. http://www.kff.org/medicaid/upload/7235-05.pdf |
| Brief Examines Lessons for Enrolling Homeless Individuals in Medicaid Under Health Reform A new brief from the Foundation's KCMU examines key lessons to consider for efforts to increase Medicaid coverage among the homeless as part of the ACA's Medicaid expansion in 2014. Given their low incomes and high uninsured rate, many homeless individuals may become eligible for Medicaid coverage under the ACA's expansion of the program to nearly all individuals with incomes up to 138 percent of the federal poverty level ($15,425 for an individual, $26,390 for a family of three in 2012). The new brief, based on eight focus group discussions with people from organizations serving homeless populations in four different cities, identifies key barriers to enrollment in Medicaid for homeless individuals, successful strategies to overcome these barriers, and key issues for state Medicaid programs to consider in attempting to serve this population. http://www.kff.org/medicaid/8355.cfm |
| More Young Adults Have Insurance After Health Care Law, Study Says The New York Times, Sept 10, 2012; by Sabrina Tavernise. The share of young adults without health insurance fell by one-sixth in 2011 from the previous year, the largest annual decline for any age group since the Centers for Disease Control and Prevention began collecting the data in 1997, according to a new report released on Monday. The estimates are drawn from a federal survey of about 35,000 households. It did not ask how the newly insured obtained coverage, but the study's author, Matthew Broaddus, a research analyst at the liberal Center on Budget and Policy Priorities, said the increased coverage for young people was almost certainly due to a provision in the Obama administration's Affordable Care Act that allows children to stay on their parents' insurance policies until their 26th birthday. http://www.nytimes.com/2012/09/10/health/policy/more-young-adults-have-health-insurance-study-says.html?_r=2 |
| SCI Federal Reform Resources September 4, 2012. The State Coverage Initiatives (SCI) Federal Reform Resources Web page (www.statecoverage.org/health-reform-resources) guides our readers through the health reform implementation process. Visit the new Federal Reform Resources page for the most up-to-date information from the states, the federal government, and health policy organizations. We know there are several places to go for health reform resources, and we thank you for using SCI as one of your trusted sources. Some of the most recent resources that can be found on our new Federal Reform page include: (1) Insurance Exchanges; (2) Insurance Market Reforms; (3) Medicaid; (4) Strategic Planning and Timelines; and, (5) Delivery System Redesign. http://www.statecoverage.org/health-reform-resources |
| APHA Updates Health Reform Webpages August 24, 2012. The American Public Health Association (APHA) recently updated their health reform website with new webpages containing new content and resources. Each page now features answers to frequently asked questions, links to APHA fact sheets and other resources, and links to other useful websites and resources. The website has links to ACA basics, ACA implementation, Prevention and Public Health Fund, Supreme Court decision and ACA advocacy. Two of the newest and most popular additions are two at-a-glance fact sheets: ACA Overview and Why Do We Need the ACA? http://www.apha.org/advocacy/Health+Reform/ |
| Implementing Insurance Exchanges - Lessons from Europe By E. van Ginneken & K. Swartz, NEJM, August 23, 2012. State-based health insurance exchanges are a key component of the health care reform law. The exchanges, which enable individuals and small employers to comparison-shop health plans, are expected to expand coverage and help contain costs through greater competition. Citing the experiences of the Netherlands and Switzerland-where exchanges have been part of the health care landscape for some time-the authors of this New England Journal of Medicine "Perspective" argue that additional measures will be needed to control costs and improve quality. Ewout van Ginneken, the lead author, is a Commonwealth Fund Harkness Fellow from the Netherlands. http://www.commonwealthfund.org/Publications/In-Brief/2012/Aug/Implementing-Insurance-Exchanges.aspx?omnicid=20 |
| Health Law Prompts Review Of Some Medigap Plans; Defining Who Gets Dependent Status By Michelle Andrews, Kaiser Health News, August 20, 2012. Occasionally, this column answers reader questions about health insurance and how the health law affects them. Here are responses to two recent queries. (Click on Link) http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2012/health-law-medigap-plans-dependent-status-michelle-andrews-082112.aspx |
| Major pharmacies to tout benefits of healthcare reform law for seniors By Elise Viebeck; Healthwatch, August 15, 2012. Prominent pharmacies such as CVS Caremark and Walgreens will promote the healthcare reform law's benefits for seniors, federal health officials announced. The joint effort between the Department of Health and Human Services (HHS) and major pharmacy chains means Medicare beneficiaries will have better access to details about the administration's health law, HHS stated. The information will be available in brochures or, in the case of Wal-Mart and Sam's Club, online. "Our pharmacy partners are helping their customers make informed healthcare decisions," HHS Secretary Kathleen Sebelius said Wednesday at a CVS location in Jacksonville, Fla. Opinion remains divided on the Affordable Care Act, which the Obama administration continues to tout. The Supreme Court upheld most of the law on June 28. "These partnerships will help people with Medicare learn more about new preventive services such as mammograms and the new Annual Wellness visit that are available at no charge for everyone with Medicare," Sebelius said. Participating retailers are CVS, Walgreens, Thrifty White, Wal-Mart and Sam's Club. Under the Affordable Care Act, people enrolled in Medicare are eligible for free preventive medical services. Some are also saving more on prescription drugs. http://thehill.com/blogs/healthwatch/health-reform-implementation/243819-major-pharmacies-to-tout-health-law-benefits-for-seniors |
| The Supreme Court and the ACA's Medicaid's Expansion Prepared by Jane Perkins; Health Advocate, Volume 4, August 2012. The United States Supreme Court has decided that the Medicaid Expansion provision of the Patient Protection and Affordable Care Act (ACA) is a "gun to the head" of the states, coercing states to expand Medicaid to additional low-income people by threatening them with the loss of existing Medicaid funding. Without question, the decision announced in National Federal of Independent Business v. Sebelius (NFIB) is one of the most significant of the last 70 years. It could affect Congress's ability to enact legislation under its Spending Clause authority to tax and spend for the general welfare. It will certainly affect how some states approach the ACA's mandate to expand Medicaid coverage by January 2014 to uninsured individuals with incomes below roughly 133% of the federal poverty level?for the most part, non-elderly adults who are not disabled. The current issue of the Health Advocate provides an overview of the Medicaid decision, responds to some frequently asked questions about the decision, and suggests reasons why states should implement the Medicaid Expansion. http://www.healthlaw.org/images/stories/2012_08_Vol_4_Health_Advocate.pdf |
| NHeLP's Medicaid Expansion Toolbox On June 28, 2012, the Supreme Court upheld most of the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius (NFIB). While the Court upheld the ACA's significant Medicaid expansion, it limited the federal government's enforcement authority if a state fails to implement the expansion - a move that is already raising questions for Medicaid programs nationwide. NHeLP's Medicaid Expansion Toolbox serves as a one-stop resource center for health advocates and states trying to make sense of the Court's decision, implications for Medicaid and policy considerations moving forward. http://www.healthlaw.org/index.php?option=com_content&view=article&id=703&Itemid=516 |
| Report: Medicaid expansion would help childless adults By Sam Baker - 08/10/12 02:21 PM ET Single adults without children would benefit significantly from the Medicaid expansion in President Obama's healthcare law, according to new research. The report, written by the Urban Institute and the Robert Wood Johnson Foundation, says roughly 82 percent of the people newly eligible for Medicaid do not have a dependent child. The Affordable Care Act expands Medicaid eligibility to 138 percent of the federal poverty level. It was initially assumed that every state would expand its Medicaid program, but the Supreme Court's healthcare decision made the expansion optional. If every state participated, about 15 million would get access to Medicaid, according to Friday's report. But several Republican governors have said they won't participate in the expansion. Majorities of the newly eligible population are white (54 percent) and male (53 percent), according to the report's authors. Roughly half of the newly eligible population is between the ages of 19 and 34. The Hill's Healthwatch. http://thehill.com/blogs/healthwatch/medicaid/243125-report-medicaid-expansion-would-help-childless-adults |
| U.S. Officials Brace for Huge Task of Operating Health Exchanges By ROBERT PEAR The New York Times, August 4, 2012 WASHINGTON - Obama administration officials are getting ready to set up and operate new health insurance markets in about half the states, where local officials appear unwilling or unable to do so. The markets, known as exchanges, are a centerpiece of President Obama's health care law, and running them will be a herculean task that federal officials never expected to perform. When Congress passed legislation to expand coverage two years ago, Mr. Obama and lawmakers assumed that every state would set up its own exchange, a place where people could shop for insurance and get subsidies to help defray the cost. More at: http://www.nytimes.com/2012/08/05/us/us-officials-brace-for-huge-task-of-running-health-exchanges.html?hpw |
| How Will the Medicaid Expansion for Adults Impact Eligibility and Coverage? Beginning in 2014, the Affordable Care Act (ACA) provides for the expansion of Medicaid eligibility to adults with incomes up to 138% FPL ($15,415 for an individual or $26,344 for a family of three in 2012), which would make millions of currently uninsured adults newly eligible for the program. The Supreme Court ruling maintains the Medicaid expansion, but limits the Secretary's authority to enforce it. This change in enforcement authority may impact state decisions to implement the expansion. This brief provides an overview of current Medicaid eligibility for adults and data on uninsured adults to provide greater insight into the implications of the ACA Medicaid expansion on coverage for adults across states. http://www.kff.org/medicaid/8338.cfm |
| Preventive Services Covered Under the Affordable Care Act If you have a new health insurance plan or insurance policy beginning on or after September 23, 2010, the following preventive services must be covered without your having to pay a copayment or co-insurance or meet your deductible. This applies only when these services are delivered by a network provider. 1. Covered Preventive Services for Adults; 2. Covered Preventive Services for Women, Including Pregnant Women; and, 3. Covered Preventive Services for Children. http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen |
| Health Law's Medical-Loss Ratio And Birth Control Coverage Requirements Kick In Today August 1, 2012, marks the deadline for insurers to refund consumers and employers if they didn't spend at least 80 percent of premiums on health care. Another provision takes effect requiring most employers to include contraceptive and other women's health services without copays in the insurance plans they offer workers. http://www.kaiserhealthnews.org/daily-report.aspx |
| Health-Care Law Poses a Technology Challenge for the Needy According to the Pew Research Center's Internet & American Life Project, 80 percent of Internet users look online for health information. However, almost 40 percent of American adults with chronic diseases do not have Internet access. Without Internet access, these patients are missing out on online resources that can help them stay healthy, interact with peers, and cope with continuing pain. Ethnic and racial minorities as well as rural and low-income people are among those who could benefit most from provisions in the health-care law, but they are also among those least connected online. While 72 percent of whites have Internet access at home, only 55 percent of African-American and 57 percent of Hispanic households can access the Internet at home. In addition, only four of every 10 households with incomes below $25,000 and 50 percent of rural Americans have wired home Internet access. http://philanthropy.com/article/Health-Care-Law-Requires-Easy/132985/ |
| Affordable Care Act and Rural America The National Rural Health Association (NRHA) has been actively engaged in the health reform debate. Check out the NRHA documents, resources and other materials related to health reform on the NRHA website. http://www.ruralhealthweb.org/index.cfm?objectid=57964C5A-3048-651A-FEA062B00D85E9F7 |
| The Partnership Center Newsletter - July 23, 2012 Dear Partners: Two weeks ago, the U.S. Supreme Court upheld the constitutionality of the health care law, the Affordable Care Act. The health care law makes significant improvements in health care, now and in the future. It is in effect and is being implemented by HHS. We have planned a series of interactive webinars on the health care law for you, faith and community leaders. The interactive webinars explain the benefits and provisions of the law and how people in your congregation and community can access care. HHS is also hosting Affordable Care Act Implementation Forums in Washington, D.C., Chicago, Denver and Atlanta. More information is available in our Upcoming Events section. Here are four key ways that the health law can help your congregation or community members NOW: Most young adults who can't get coverage through their jobs can stay on their parents' insurance plans until age 26; Children with pre-existing conditions cannot be discriminated against in receiving insurance coverage (starting in 2014, adults with pre-existing conditions cannot be discriminated against in insurance coverage); There is increased access to preventive services: Insurance plans now offer many preventive services without a co-pay or deductible; There are no lifetime limits on insurance coverage which means that insurers won't be able to deny, cap or limit your coverage if you get sick. The health care law also improves access to mental health and substance use disorder services. In 2014, mental health and substance use disorder services will be part of the essential benefits package, a set of health care service categories that must be covered by certain plans, including all insurance policies that will be offered through the Exchanges and Medicaid. For the 30 million Americans who don't yet have health insurance, starting in 2014 the law will ensure an array of quality, affordable, private health insurance plans to choose from through affordable insurance exchanges. Tax credits will make buying insurance more affordable. States will have the option of expanding their Medicaid program to cover people who have incomes up to 133% of the federal poverty level, approximately $15,000 for an individual and $30,000 for a family of four. Community health centers offer primary care with a sliding payment scale to help those without insurance. Each of these improvements will help fill gaps in our health care system. If you have questions about the health care law, you can always email us at ACA101@hhs.gov. As always, please feel free to email us at Partnerships@hhs.gov or call us at 202-358-3595 to let us know how we can support your work in congregations and communities. Sincerely, Alexia Kelley, Director Center for Faith-Based & Neighborhood Partnerships U.S. Department of Health & Human Services http://www.hhs.gov/partnerships/resources/newsletter/072312.html |
| Affordable Care Act Conference Calls You are invited to Interactive Webinars on the Health Care Law, July 24 - August 8, 2012. http://www.hhs.gov/partnerships/resources/aca_101-invite.html |
| HHS Affordable Care Act Implementation Forums The Department of Health & Human Services has revised its schedule of forums to foster community conversations about the implementation of the Affordable Care Act. The forum in Denver will now be held on August 22, 2012 (not August 10, 2012 as announced last week). HHS will also hold a forum specifically to focus on needs of tribal populations in the Exchange; that forum will take place in Denver on August 9, 2012. HHS states that location and registration information for both meetings will be forthcoming. http://www.colorado.gov/healthreform/ |
| Chronic Disease Prevention: Saving Lives, Saving Money The Alliance for Health Reform and the Robert Wood Johnson Foundation sponsored a July 13 luncheon briefing to discuss whether or not public health investments can help prevent chronic disease and reduce escalating health care costs. http://www.allhealth.org/briefing_detail.asp?bi=251 |
| Two Medical Students Navigate the Health Care Maze Now Elisabeth Askin and Nathan Moore, medical students from the Washington University School of Medicine in Saint Louis, have set out to help all of us understand. Motivated by their own anxiety about the future, they have written "The Health Care Handbook" (self-published with their medical school), an astonishingly clear "user's manual" that explains our health care system and the policies that will change it. It's the kind of book to share not only with your doctors and colleagues, but with your friends and Aunt Dorothy, too. See full article by Pauline Chen, MD, The New York Times, July 12, 2012. http://well.blogs.nytimes.com/2012/07/12/two-medical-students-navigate-the-health-care-maze/?ref=health#comments |
| A Guide to the Supreme Court's Affordable Care Act Decision This policy brief describes the Supreme Court's decision on the Affordable Care Act and looks ahead to the implementation of health reform now that questions about the constitutionality of the law have been resolved. http://www.kff.org/healthreform/8332.cfm |
| Frequently Asked Questions (FAQs) On this website are a number of Frequently Asked Questions (FAQs) about funding available to States under Affordable Care Act Section 1311(a). These FAQs are applicable to the Funding Opportunity Announcement (FOA), released in June 29, 2012, Cooperative Agreement to Support Establishment of Affordable Care Act's Health Insurance Exchanges, and related 1311 Funding ("new FOA"), which can be found at www.grants.gov, search for CFDA number 93.525. They also apply to prior Funding Announcements, most recently amended November 29, 2011 (old "FOAs") found at: https://www.grantsolutions.gov/gs/preaward/previewPublicAnnouncement.do?id=12241. http://cciio.cms.gov/resources/factsheets/hie-est-grant-faq-06292012.html |
| The ACA: How the Supreme Court Ruling Affects Nurses By Jennifer Olin, BSN, RN. Thursday, June 28, 2012 will go down a landmark date in the nearly 100-year-long battle for comprehensive healthcare reform in this country. That's right, it wasn't any president that most of us were even alive to remember who started this battle. Yesterday, Teddy Roosevelt's progressive beliefs, in among other things, revisions to the health insurance industry, were finally supported by law. It took 94 years and several more presidents and congresses to finally pass comprehensive health care reform in this country. However, the legislative victory met immediate judicial resistance. One of the central issues with the Affordable Care Act (ACA) was whether Congress had the power to require individuals to buy health insurance. Opponents argued that this requirement violated the Commerce Clause of the Constitution by forcing Americans to purchase health insurance against their will. http://www.rncentral.com/blog/2012/the-aca-how-the-supreme-court-ruling-affects-nurses/ |
| FACT SHEET: The Affordable Care Act: Secure Health Coverage for the Middle Class The Supreme Court's decision to uphold the Affordable Care Act ensures hard-working, middle class families will get the security they deserve and protects every American from the worst insurance company abuses. This law was also specifically designed to give States the resources and flexibility they need to tailor their approach to their unique needs. With the uncertainty about the Court's decision behind us, it's now time to focus on implementing this law in a smart and non-bureaucratic way that works for the middle class. Benefits and Protections for the Middle Class: The Affordable Care Act includes numerous provisions to keep health care costs low, promote prevention, and hold insurance companies accountable. If you?re one of the 250 million Americans who already have health care - whether through private insurance, Medicare, or Medicaid - the Affordable Care Act is already making your coverage more secure. http://www.whitehouse.gov/the-press-office/2012/06/28/fact-sheet-affordable-care-act-secure-health-coverage-middle-class |
| Obama administration and states move forward to implement health care law Health and Human Services Secretary Kathleen Sebelius announced today a new funding opportunity to help states continue their work to implement the health care law -- the Affordable Care Act. When the law is fully implemented in 2014, the affordable insurance exchanges will provide people and small businesses with one-stop shops to find, compare and purchase affordable, high-quality health insurance. Today's announcement makes more funding available to build all models of affordable insurance exchanges available to states. HHS also issued further guidance today to help states understand the full scope of activities that can be funded under the available grant funding as they work to build exchanges http://www.hhs.gov/news/press/2012pres/06/20120629a.html |
| Prevention Provisions in the Affordable Care Act, Issue Brief, American Public Health Association The Affordable Care Act, if it is adequately funded, effectively implemented, and creatively leveraged through public and private-sector partnerships, will mark the turning point in the fundamental nature of our health system, initiating the transformation of our health system from one that treats sickness to one that promotes health and wellness. This issue brief begins (Section III) by summarizing the state of public health in the United States, including some measures of the growth of preventable diseases. Section IV describes the major provisions of the Affordable Care Act that address prevention through: (1) investing in public health; (2) educating the public; (3) expanding insurance coverage and requiring that health insurance include recommended preventive benefits; and (4) building capacity for better prevention in the future through demonstrations, research and evaluation. http://www.apha.org/NR/rdonlyres/763D7507-2CC3-4828-AF84-1010EA1304A4/0/FinalPreventionACAWeb.pdf |
| After The Ruling: A Consumer's Guide The Supreme Court Thursday, June 28, 2012, upheld the 2010 federal health care law, dismissing the challenge by states to the law's requirement that individuals get insurance. The justices, however, did give states the right to opt out of a critical provision requiring them to expand Medicaid programs for the poor and disabled. This guide contains ten FAQs about some of the law's provisions that are already up and running as well as major features of what's to come. http://www.kaiserhealthnews.org/Stories/2012/March/22/consumer-guide-health-law.aspx?utm_source=specialnotice&utm_medium=email&utm_campaign=062812 |
| Supreme Court of the United States Decision on the Patient Protection and Affordable Care Act The full 193-page Supreme Court Decision on the ACA of June 28, 2012 is available online. http://msnbcmedia.msn.com/i/msnbc/Sections/NEWS/scotus_opinion_on_ACA_from_msnbc.com.pdf |
| Supreme Court Lets Health Law Largely Stand By Adam Liptak and John H. Cushman Jr, June 28, 2012, The New York Times. WASHINGTON -- The Supreme Court on Thursday upheld most of President Obama's health care overhaul law, saying it was authorized by Congress's power to levy taxes. The vote was 5 to 4, with Chief Justice John G. Roberts Jr. joining the court's four more liberal members. The decision was a victory for President Obama and Congressional Democrats, affirming the central legislative pillar of Mr. Obama's presidency. The ruling upheld the individual mandate requiring nearly all Americans to obtain health insurance or pay a penalty. http://www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html?pagewanted=all |
| State Coverage of Preventive Services for Women under Medicaid: Findings from a State-Level Survey Medicaid is a critical source of health coverage and long-term care for millions of low-income women. Federal Medicaid rules require that the program cover many, but not all, important preventive screening services, but states also have considerable latitude in establishing which preventive services are covered for adults and whether or not to charge enrollees copayments for these services. As such, there is sizable variability by state in Medicaid coverage of preventive services for adults. As of 2014, these state policy choices will affect millions more women who will be newly eligible for Medicaid after the implementation of the Affordable Care Act (ACA). The ACA will also provide an enhanced federal matching payment to state Medicaid programs that cover certain recommended preventive services without cost-sharing starting in 2013. The Kaiser Commission on Medicaid and the Uninsured (KCMU) and Health Management Associates (HMA) surveyed Medicaid officials in all 50 states and the District of Columbia in 2010 to collect baseline data on state coverage of preventive services prior to ACA implementation. This brief reviews Medicaid's role in covering preventive care for women, presents findings of importance to women from the survey, and discusses the implications for women on Medicaid following the implementation of health reform. http://www.kff.org/womenshealth/8330.cfm |
| Health care law saves consumers over $1 billion On June 21, 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that 12.8 million Americans will benefit from $1.1 billion in rebates from insurance companies this summer, because of the Affordable Care Act's 80/20 rule. These rebates will be an average of $151 for each family covered by a policy. The health care law generally requires insurance companies to spend at least 80 percent of consumers? premium dollars on medical care and quality improvement. Insurers can spend the remaining 20 percent on administrative costs, such as salaries, sales, and advertising. Beginning this year, insurers must notify customers how much of their premiums have been actually spent on medical care and quality improvement. Insurance companies that do not meet the 80/20 standard must provide their policyholders a rebate for the difference no later than Aug. 1, 2012. The 80/20 rule is also known as the Medical Loss Ratio (MLR) standard. http://www.hhs.gov/news/press/2012pres/06/20120621a.html |
| Understanding the Difference Between Medicaid and EHB Benchmarks: How These Systems Work and Interact Prepared by Jina Dhillon and Michelle Lilienfeld. As health reform implementation moves forward, two health insurance "benchmark" systems are emerging as the critical determinants of the care and services that millions of individuals will receive beginning in 2014. The first is the Medicaid benchmark, which already exists. The second is the new Essential Health Benefits (EHB) benchmark, which sets the standard for benefits packages that individuals and employees of small businesses will receive through the Exchanges, Basic Health Plans, and other coverage options established by the Affordable Care Act (ACA). This article provides an overview of the Medicaid and EHB benchmarks, and briefly describes some of the interactions between the two. NHeLP will release further analyses of these interactions in coming months. Health Advocate, Vol 2, June 2012. http://www.healthlaw.org/images/stories/2012_06_Vol_2_Health_Advocate.pdf |
| Many Lacked Preventive Care Before Health Reform Law: U.S. Report THURSDAY, June 14 (HealthDay News) -- Prior to the passage of the Affordable Care Act in 2010, only about half of U.S. adults received preventive health services such as screenings, consultations and prescriptions, government researchers report. Increased use of preventive health services could save tens of thousands of lives, according to the researchers from the U.S. Centers for Disease Control and Prevention. The investigators also noted that the Affordable Care Act -- which provides coverage for many preventive tests -- could lead to greater use of such services. Provisions in the Affordable Care Act that could increase the use of preventive services include a requirement that new private health insurance plans cover recommended preventive services with no cost-sharing. In addition, the health care law requires coverage for a new annual wellness visit under Medicare and eliminates cost sharing for recommended preventive services provided to Medicare beneficiaries. The law also offers state Medicaid programs financial incentives to cover preventive services for adults and supports efforts to improve public education about the benefits of preventive services. http://www.philly.com/philly/health/topics/HealthDay665762_20120614_Many_Lacked_Preventive_Care_Before_Health_Reform_Law__U_S__Report.html |
| MyCare: Helps Health Care Consumers Understand Benefits and Rights MyCare is an initiative to educate Americans about new programs, benefits and rights under the health care law. People across the country are encouraged to share their own stories by using the Twitter hashtag #MyCare or visiting facebook.com/HealthCareGov. The health care law, the Affordable Care Act, was signed into law two years ago on March 23, 2010. The law prohibits insurance companies from dropping coverage when people get sick through a practice called "rescission", annual or lifetime limits, and, in 2014, will guarantee health insurance for all Americans including anyone with a pre-existing condition. Insurance companies are also required to cover preventive care like mammograms and other cancer screenings. http://www.healthcare.gov/mycare |
| Duals: The National Health Reform Experiment We Should Be Talking More About The Center for Medicare & Medicaid Services (CMS) and 26 states are moving to launch a large scale managed care demonstration project potentially involving millions of the poorest, sickest, most expensive Medicare and Medicaid beneficiaries, the so-called dual eligibles. The experiment is getting more and more attention from policy experts, but with controversial issues like the survival of the Affordable Care Act and converting Medicare to a premium support program grabbing the limelight, it has otherwise flown under the radar screen. The 9.1 million dual eligible beneficiaries represent just a small share of the 97 million beneficiaries served by either Medicare or Medicaid but account for about 35 percent of all dollars spent by the two big programs. As a group they are sicker than other Medicare beneficiaries -- half have three or more chronic conditions and six in ten have cognitive limitations, leading to increased use of health and long-term care services. While most are over age 65, four in ten are younger with permanent disabilities. Two of three are women. A striking 56 percent have incomes of less than $10,000 per year. http://www.kff.org/pullingittogether/dual-eligibles-health-reform.cfm |
| Analysis: HHS has missed nearly half of healthcare law's deadlines The Health and Human Services Department (HHS) has missed nearly half of its legal deadlines while implementing President Obama's healthcare law, according to an analysis by the American Action Forum (AAF). HHS has faced 42 statutory deadlines in the roughly two years since the Affordable Care Act became law and it missed 20 of them, according to the AAF's count. The highest-profile item on the list of missed deadlines is the CLASS, or Community Living Assistance Services and Supports, program, which would have provided insurance for long-term care such as nursing-home stays. But HHS decided not to implement the program, saying it simply couldn't work as it was written. Aside from CLASS, federal regulators have at least begun work on all of the provisions AAF identified. Several have been finalized, but later than the law had called for. http://thehill.com/blogs/healthwatch/health-reform-implementation/231297-analysis-hhs-has-missed-nearly-half-of-healthcare-laws-deadlines |
| State Coverage Initiatives (SCI) Program The State Coverage Initiatives (SCI) program provides timely, experience- and evidence-based information and assistance to state leaders in order to help them move health care reform forward at the state level. SCI offers an integrated array of policy and technical assistance services and products to help state leaders with coverage expansion efforts as well as with broader health care reform. Our team of policy experts tailors its approach to meeting state decision makers' needs within the context of each state's unique fiscal and political environment. SCI is a national program of the Robert Wood Johnson Foundation administered by AcademyHealth. The SCI strategy focuses on three key elements to build the policy making and technical capacity of the states: (1) Supports a community of state officials that can learn from each other, share best practices, test new initiatives and encourage action; (2) Provides unbiased information that brings strong research and analysis to the issues states are confronting; and, (3) Offers responsive policy and technical assistance to improve state policymakers' ability to make informed policy decisions. http://www.statecoverage.org/ |
| Health Care Costs: The Role of Technology and Chronic Conditions Many factors have been cited as health care cost drivers, including demography, geography, economics and health status. But there is little agreement on how much each factor contributes to overall costs. This briefing offered an in-depth look at two of the most often cited cost drivers -- technology and chronic conditions. Much has been said about spending in governmental health care programs, notably Medicare and Medicaid. But employers, families and other payers have also experienced steady increases in health care spending. This is the second event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. The series marks the Alliance for Health Reform's 20th year of promoting informed and balanced discussion of health policy issues. http://allhealth.org/briefing_detail.asp?bi=238 |
| 5 must-dos for U.S. healthcare reform success from LinkedIn health groups There's an interesting discussion brewing in several healthcare-focused LinkedIn groups that was sparked by this question: What things must healthcare reform include to be successful? Anthony Wunsh, president and CEO of Medical Pay Solutions, asked this question to thousands of industry stakeholders in about 20 LinkedIn groups that included Healthcare Executives Network and Society of Physician Entrepreneurs. A lively and insightful discussion has ensued, with suggestions of everything from mandatory and universal coverage to eliminating insurance for services costing under $10,000. http://medcitynews.com/2012/05/5-must-dos-for-us-healthcare-reform-success-from-linkedin-health-groups/?utm_source=rss&utm_medium=rss&utm_campaign=5-must-dos-for-us-healthcare-reform-success-from-linkedin-health-groups |
| Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states will be necessary to meet implementation timelines?exchanges must be fully operational by January 1, 2014 and the Department of Health and Human Services will begin certifying exchange readiness by January 2013. Recognizing the urgency, many states initiated planning activities soon after the passage of the ACA, creating task forces or workgroups to study exchange design options. Many also applied for and were awarded federal Level 1 Exchange Establishment grants to fund planning activities, including the development of information technology (IT) systems. However, legal challenges to the ACA have created uncertainty for states and have led some to slow or halt exchange planning efforts in recent months. The implications of these decisions are significant. Delays in exchange planning mean fewer states will likely meet the timelines for implementing a state-based exchange and will instead be forced to default to a federal exchange or a federal-state partnership model. http://www.kff.org/healthreform/quicktake_SCOTUS_exchanges.cfm |
| Health Information & the Law The George Washington University's Hirsh Health Law and Policy Program is proud to announce a new online resource, Health Information and the Law (HealthInfoLaw.org). This new website, developed with support from the Robert Wood Johnson Foundation, is an online guide to federal and state laws governing access, use, release, and publication of health information. Constantly updated, the site addresses the current legal and regulatory framework of health information law and changes in the legal and policy landscape impacting health information law and its implementation with commentary and key documents. http://www.healthinfolaw.org/ |
| More Than Half of Individual Health Plans Offer Coverage That Falls Short of What Can Be Sold Through Exchanges as of 2014 More than half of Americans who have health coverage through the individual insurance market are in plans that would not meet the standards for "essential benefits" set by the Affordable Care Act. Most people enrolled in employer group plans, however, have more comprehensive coverage with less cost-sharing. http://www.commonwealthfund.org/Publications/In-the-Literature/2012/May/Individual-Health-Plan-Coverage-Falls-Short.aspx |
| New Tutorial on Dual Eligibles In this tutorial, MaryBeth Musumeci, senior health policy analyst for the Kaiser Commission on Medicaid and the Uninsured, focuses on the 9 million low income seniors and people with disabilities who receive coverage through both Medicare and Medicaid -- a population with complex needs and very high health and long-term care expenses. This tutorial provides a closer look at the characteristics of dual eligibles, the types of services and coverage they receive from each program, and how program spending for this population is allocated. Lastly, Musumeci discusses challenges with coordinating care across the two very different programs and reviews the Affordable Care Act provisions that address these issues. http://www.kaiseredu.org/Tutorials-and-Presentations/Dual-Eligibles.aspx |
| Implementing health reform: A Public Health Approach The history of public health in the United States is packed with prized and hard-fought gains in the health of individuals, families and entire communities. At the same time, the field's uphill struggles only underscore the substantial failings of a health system built almost entirely on a foundation of treatment, instead of prevention. For public health practitioners working to fill the widening cracks in a crumbling system, the evidence for change is clear: record numbers of uninsured, rising rates of preventable chronic diseases, out-of-control health spending and dire warnings that today's children may have shorter life expectancies than their parents. Fortunately, with the 2010 passage of the Patient Protection and Affordable Care Act, public health practitioners have a number of new tools at their disposal as well as a momentous opportunity to transform the way good health is delivered and sustained. How to wield those new tools and opportunities as well as the law's landmark investments in prevention and public health was the exclusive focus of APHA's 2011 Midyear Meeting, which was held June 23-25 in downtown Chicago. This report chronicles the myriad discussions that took place among the meeting's hundreds of attendees and highlights the central themes and recommendations that came out of the three-day event. http://www.apha.org/NR/rdonlyres/F3AC094B-868C-4D17-A728-67CE3D8DDFCB/0/implementing_HlthReform_2.pdf |
| Achieving Better Quality of Care for Low-Income Populations: The Roles of Health Insurance and the Medical Home in Reducing Health Inequities In the United States, uninsured and low-income adults experience substantial health and health care inequities when compared with insured and higher-income individuals. A new analysis of the Commonwealth Fund 2010 Biennial Health Insurance Survey demonstrates that when low-income adults have both health insurance and a medical home, they are less likely to report cost-related access problems, more likely to be up-to-date with preventive screenings, and report greater satisfaction with the quality of their care. Moreover, the gaps in health care between them and higher-income populations are significantly reduced. The Affordable Care Act includes numerous provisions that will significantly expand health insurance coverage, especially to low-income patients, as well as provisions to promote medical homes. Along with supporting the full implementation of coverage expansions, it will be important for public and private stakeholders to create opportunities that enhance access to medical homes for vulnerable populations. http://www.commonwealthfund.org/Publications/Issue-Briefs/2012/May/Achieving-Better-Quality-of-Care-for-Low-Income-Populations.aspx |
| United for Reform Resource Center - UnitedHealthcare Welcome to a new era of health care. When President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law on March 23, 2010, we entered a new era of comprehensive health reform. The act includes several provisions which are designed to expand coverage, control health care costs, and improve the health care delivery system. Our goal at UnitedHealthcare is simple: to help you understand what health reform means for you. New laws. New benefits. From children to seniors, changes are happening ? we are with you every step of the way. http://www.uhc.com/united_for_reform_resource_center.htm |
| Realigning Health with Care: How to Deliver More with Less This month's Stanford Social Innovation Review cover story, "Realigning Health with Care: Lessons in Delivering More with Less," examines how America can broaden its understanding of health care and realign resources to expand it beyond medical treatment alone. In so doing, the U.S. health care system could significantly improve health outcomes and reduce inefficiencies. Authors Rebecca Onie of Health Leads, Paul Farmer of Partners in Health, and Heidi Behforouz of the Prevention and Access to Care and Treatment project suggest the present climate of reform in U.S. health care provides a rare opportunity to improve the current system by redefining the scope of health care, the workforce that provides it, and where it is delivered. In many resource-poor nations, front-line providers and health care decision-makers recognize the "stubborn relationship between poverty and ill health, and?start from the premise that health care must mean more than medicine." http://rwjf-cbha.createsend1.com/t/ViewEmail/r/EAC5FAAAF4DF5FDD/E4BDAFBF06DFC75C2540EF23F30FEDED |
| Decoding Medicaid Care Delivery and Financing Models: A Glossary of Widely Used Terms As care delivery and financing models in Medicaid have multiplied, so has the terminology used to refer to them. This glossary seeks to clarify and define the terms that are widely used to describe the diverse approaches that states are taking to reform the way they organize and pay for care for Medicaid beneficiaries. Although some terms are also used in other contexts, including private insurance and Medicare, this glossary confines itself to how they tend to be applied in the context of Medicaid. http://www.kff.org/medicaid/8313.cfm |
| Health Reform Source This website hosted by The Henry J. Kaiser Family Foundation covers the basics about health reform in addition to research and analysis, news and notes, public opinion and state-by-state data. http://healthreform.kff.org/ |
| Health Reform Hits Main Street Confused about how the new health reform law really works? This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Learn more about how the health reform law will affect the health insurance coverage options for individuals, families and businesses with the interactive feature "Illustrating Health Reform: How Health Insurance Coverage Will Work." http://healthreform.kff.org/the-animation.aspx?source=QL |
| How is the Affordable Care Act Leading to Changes in Medicaid Today? State Responses to Five New Options This policy brief examines how states in every region have responded to five key opportunities available under the health reform law to help them prepare for the significant expansion of Medicaid in 2014. The options covered in the brief include incentives for states to get an early start on the Medicaid coverage expansion; increased federal funding to upgrade Medicaid eligibility systems; money to improve care for beneficiaries with chronic conditions by providing "health home" services; special funding for chronic disease prevention; and help in developing service delivery and payment models that integrate care for beneficiaries who are dually eligible for Medicare and Medicaid. http://www.kff.org/medicaid/8312.cfm |
| Center for Consumer Information and Insurance Oversight (CCIIO) The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many provisions of the Affordable Care Act, the historic health reform bill that was signed into law March 23, 2010. CCIIO oversees the implementation of the provisions related to private health insurance. The CCIIO works closely with governors and the state insurance commissioners, consumers, and stakeholders to ensure the new law best serves the American people. http://cciio.cms.gov/index.html |
| HealthReformGPS Health Reform GPS is a joint project of the Robert Wood Johnson Foundation and the Hirsh Health Law and Policy Program of the George Washington University School of Public Health and Health Services. With passage of H. R. 3590, the Patient Protection and Affordable Care Act of 2010, and its companion bill H.R. 4872, the Health Care and Education Reconciliation Act of 2010, the major work of turning law into real change begins. Implementing any law is a complex policymaking process in its own right. Like the passage of a statute, the process of implementation is one in which government agencies, acting under ongoing Congressional oversight, interpret the law and more clearly define the policies that will guide the health care system. In doing so, they are guided by the major health system stakeholders such as patients and consumers, employers and unions, health insurers, and health care providers. http://www.healthreformgps.org/ |
| Making Health Literacy Real: The Beginnings of My Organization's Plan for Action This easy-to-use template from the Centers for Disease Control and Prevention (CDC) helps you and your organization get started in developing your own plan to change organizational and professional practices to improve health literacy. Developing a plan for action does not have to be an overwhelming process and this template can help you think through the steps needed from getting buy-in and conducting an assessment to developing goals and monitoring progress. http://healthliteracywisconsin.org/resources.jsp?sectionid=204&id=205 |
| Health Reform to Require Insurers to Use Plain Language in Describing Health Plan Benefits, Coverage People in the market for health insurance will soon have clear, understandable and straightforward information on what health plans will cover, what limitations or conditions will apply, and what they will pay for services thanks to the Affordable Care Act ? the health reform law ? according to final regulations published today. The marketing materials that insurers use can sometimes make it difficult for consumers to understand exactly what they are buying. The new rules, published jointly by the Departments of Health and Human Services, Labor and Treasury, require health insurers and group health plans to provide concise and comprehensible information about health plan benefits and coverage to the millions of Americans with private health coverage. The new rules will also make it easier for people and employers to directly compare one plan to another. http://www.hhs.gov/news/press/2012pres/02/20120209a.html |
