Affordable Care Act, Education, Health Reform, Medicaid, Pennsylvania, Philadelphia, Uncategorized

Affordable Care Act (ACA) Education & Outreach

This weekend I had the opportunity to discuss the Affordable Care Act (ACA) with Pennsylvania Senator Vincent Hughes and Philadelphia Department of Behavioral Health & Intellectual disABILITY Services Commissioner Arthur Evans on Philadelphia radio show Philly Speaks on 100.3 FM. The show gave us a chance to demystify “Obamacare” and what it really means for individuals. A few of the key messages that were expressed include:

  • Getting insurance coverage is essential for many individual and societal reasons.
  • The new Health Insurance Marketplace provides an opportunity for individuals to purchase health insurance on a more “level playing field” than in the past.
  • Through the Marketplace individuals could receive financial assistance to purchase coverage.
  • The Marketplace will screen individuals for public and private health insurance options and financial assistance to purchase insurance.
  • Individuals with behavioral health needs (mental health and substance use challenges) will have an increased opportunity to access services due to the Affordable Care Act’s provisions.
  • Expanding Medicaid in Pennsylvania is a “no brainer” and will be a huge missed opportunity if the state administration does not act soon.
  • Healthcare.gov, localhelp.healthcare.gov, and 1-800-318-2596 are valuable resources for individuals to learn more about their options and places to get in-person assistance.

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Affordable Care Act, Health Insurance Exchange, Health Reform

Health Insurance Marketplace | Help!

Starting tomorrow many individuals who have never purchased health insurance before will be able to do so through the new Health Insurance Marketplaces established by the Affordable Care Act. If you will be using the Marketplace or assisting others there are many resources available. Below is a list of resources that I find most helpful:

1. Find Local Help from Healthcare.gov: https://localhelp.healthcare.gov/

  • Simply enter your zip code and you will be given a list of local organizations that can help individuals.
  • Results can be narrowed by organizations that administer Medicaid or CHIP or that have language access capability.

2. Helping Consumers Understand and Use Health Insurance in 2014 from the Institute of Medicine: http://iom.edu/~/media/Files/Perspectives-Files/2013/Discussion-Papers/BPH-Helping-Consumers-Understand.pdf

  • This 16 page report clearly explains the Health Insurance Marketplace and other changes occurring due to the Affordable Care Act.
  • Written in simple language and contains helpful graphs/charts/illustrations.
  • Very useful for anyone who anticipates helping individuals with the Marketplace.

3. Subsidy Calculator from Kaiser Family Foundation: http://kff.org/interactive/subsidy-calculator/

  • Interactive tool allows individuals to enter their income information to find out if they qualify for a tax subsidy or tax credit to purchase health insurance in the Marketplace.

4. How do I get an exemption from the fee for not having health coverage? from Healthcare.gov:  https://www.healthcare.gov/exemptions/

  • Provides easy-to-understand information about the exemptions that exist to the individual mandate provision of the Affordable Care Act.
  • Explains that an exemption exists for individuals in states that do not expand Medicaid eligibility. Individuals that would otherwise become eligible will not face a penalty for not having coverage beginning in 2014.
Uncategorized

Thoughts on Governor Corbett’s coming announcement re: Medicaid expansion in Pennsylvania

Public health advocates in Pennsylvania have been working tirelessly to influence Governor Corbett to “opt in” to Medicaid expansion since the U.S. Supreme Court made its surprising decision on June 28, 2012 regarding the Affordable Care Act (ACA).  The Governor’s office has leaked to the press that tomorrow we will get the news we have been waiting for during a big announcement the Governor is set to deliver.  One would think that advocates should welcome this news; however instead of celebrating, many of us are gearing up for our next challenge: explaining to the public and the legislature why we will not support Governor Corbett’s Medicaid expansion proposal.

For months Governor Corbett adamantly opposed expanding Medicaid eligibility citing misleading financial analyses, over reliance on the Medicaid program, and unsubstantiated fears that the federal government will “break its promise” regarding the 100% federal matching rate for the program for years 2014, 2015, and 2016.  More recently, as the Governor’s political popularity continues to dwindle, he has moved from adamantly opposing expansion to considering options within expansion.  Based on recent statements by the Governor, the Pennsylvania Department of Welfare Secretary, Beverly Mackereth, and the Insurance Commissioner, Michael Consedine, it is very likely that the Governor’s proposal will be similar to those of Arkansas and Iowa.  Governor Corbett favors privatization and it is likely he will propose expanding Medicaid eligibility for individuals, but instead of enrolling them into the traditional Medicaid program, the newly eligible individuals will be enrolled into the private health insurance plans on the Marketplace. In addition to this, the Governor will likely request a waiver from moving children in households with incomes up to 138% of the federal poverty level from CHIP into the Medicaid program; a provision of the ACA to which the Governor has expressed great opposition.  Other items the Governor might propose as part of the Medicaid expansion in Pennsylvania could include work requirements and increased co-payments for services. With the maintenance of effort requirement of the ACA expiring at the end of the year, advocates also fear Governor Corbett’s expansion plan will unfortunately come with a reduction in the current Medicaid benefit, negatively impacting our most vulnerable residents.

Governor Corbett is making the issue of Medicaid expansion in Pennsylvania needlessly complex in order to satisfy both a Republican base and to improve his popularity overall.  In doing so, the Governor will continue to delay the opportunity for approximately 600,000 residents to get comprehensive health coverage.  Some of the messages we need to get across are clear: (1) The current Medicaid program in Pennsylvania is efficient and works to provide comprehensive coverage to those who need it most; and (2) Pennsylvania residents will pay for Medicaid expansion through income tax regardless of whether we expand or not.  The government should expand in a way that provides the best services to individuals, not the highest profits for corporations.