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Issues in Health Reform

What role for Extension in consumer enrollment in the online health insurance marketplaces?

Our national colleagues have been giving quite a bit of thought to this.  There is a fact sheet those folks put together to help guide Extension leadership on thinking about Extension’s role in the Navigator program.  Health Insurance Navigator Fact Sheet 4 30 13  It defines what a navigator is and lays out the different options for Extension systems.

Know that in Kansas there are currently several groups considering submitting a proposal to the feds to be funded as one of the navigators.  Kansas will be awarded two grants, one has to go to a consortium type group.  Total funding will be $600,000.  That is likely not enough money to do the task so folks that extend the reach of those dollars, perhaps through train the trainer initiatives (yes, Extension) may be viable partners in these efforts.

Also useful is the J of Extension commentary published in the Oct issue by our Maryland colleague Bonnie Braun for thinking more broadly about Extension’s role in other aspects of the Affordable Care Act.

Further, you can link to this webinar, specifically the section done by my Wisconsin colleague Mary Meehan-Strub and myself on what role for Extension in all of our program, starting at hour 1:27. “Implications for UW Extension and county colleagues.”

The need for consumer assistance enrolling in online marketplace (the Exchanges)

January 1, 2014 is the day that the new insurance plans begin for consumers who will be enrolling for those plans through the online marketplace (the Exchange).  In Kansas as many other states the federal government is responsible for designing what that online marketplace will look like.

Enrollment in those plans will be Oct 1, 2013 – March 31 2014 (the extended date currently for this first year only).  This article today basically lays out the herculean task of getting so many new people enrolled.  I trust Kaiser Health News to put together fact based stories. http://www.kaiserhealthnews.org/Stories/2013/May/05/insurance-exchanges-marketplaces-navigators-consumers.aspx

Though the information is not specific to Kansas we will not be all that different.  We have over 368,000 uninsured, some percentage of which are expected to need assistance in enrolling.  See this Kansas Health Institute publication for details on how many folks are expected to enroll.

 

Webinars on the Affordable Care Act hosted by the Department of Health and Human Services, some in Spanish

May 2013 Webinars on the Health Care Law

 

 

The HHS Partnership Center continues to host a series of webinars for faith and community leaders. All webinars are open to the public and include a question and answer session.

 

To participate in one of the webinars, please select your preferred topic from the list below and submit the necessary information. Please click on the title of the webinar and fill out the registration form. After registering you will receive an e-mail confirmation containing information about joining the webinar. Please contact us at ACA101@hhs.gov  if you have problems registering or if you have any questions about the health care law.

 

NEW! Update on the Navigator Program

May 7 at 3:00 pm ET

Please join our webinar to learn about the Navigator, In-Person Assister and Certified Application Counselor programs and how to enroll others in the Health Insurance Marketplace. Information on the Navigator proposed rules will also be discussed. Participation will be limited to the first 1,000 people who join the webinar.

 

NEW TIME! Questions and Answers on the Health Care Law

May 10 at 2:00 pm ET

Please join us for this interactive webinar. Questions that have been asked about the health care law will be answered as well as new questions submitted online. Please send your questions prior to the webinar to ACA101@hhs.gov.

 

 

Make the Call, Don’t Miss A Beat!

 

May 16 at 12:00 pm Noon ET

 

You are invited to a webinar titled Make the Call, Don’t Miss a Beat! a webinar seeking to educate and empower women age  50+ and to encourage women to call 9-1-1 immediately when they experience any of the seven symptoms of a heart attack, and to do the same for their mothers, sisters, and friends. The HHS Office on Women’s Health’s new campaign builds on OWH’s successful “Make the Call, Don’t Miss a Beat” campaign, that began in 2011.

 

 

Haga La Llamada¡No Pierda Tiempo!

 

El 16 de mayo del 2013 a las 1:00 PM (Tiempo del Este)

 

May 16 at 1:00 pm ET

 

Usted está invitado/a a participar a un Webinar en español sobre la campaña de concientización sobre ataques al corazón dirigida a mujeres latinas de 50 años en adelante. La campaña, “Haga la Llamada. ¡No Pierda Tiempo!” tiene como objetivo educar y motivar a las mujeres de habla hispana a llamar al 9-1-1 inmediatamente cuando se presente alguno de los siete síntomas de un ataque al corazón y a hacer lo mismo por sus madres, hermanas y amigas. Es una campaña lanzada por La Oficina de la Salud de la Mujer del Departamento de Salud  y Servicios Humanos y el webinar es en colaboración con la HHS Center for Faith-Based and Neighborhood Partnerships.

 

 

The Health Care Law 101 (in Spanish)

 

May 21 at 3:00 pm ET

 

A presentation on the main provisions in the Affordable Care Act, the health care law, and how to access care in your community in Spanish. Information on the Health Insurance Marketplace, how to help enroll others in health insurance, and how to receive updates on implementation of the law will be shared.

 

 

The Health Care Law 101

 

May 23 at 2:00 pm ET

 

A presentation on the main provisions in the Affordable Care Act, the health care law, and how to access care in your community. Information on the Health Insurance Marketplace, how to help enroll others in health insurance, and how to receive updates on implementation of the law will be shared.

 

 

Lisa M. Carr, MSW, Associate Director

HHS Center for Faith-Based and Neighborhood Partnerships

202-260-1931

Lisa.carr@hhs.gov

www.hhs.gov/partnerships

Is Health Reform Responsible for Premium Increases?

 

Well, depends who you ask.   Just do a Google search on “premiums and health care reform” and a plethora of journal articles, research studies and opinions will claim one of two main arguments:

 

1.) Obamacare is directly responsible for ongoing increases to consumers’ health care costs.  Premium costs are rising because of the health reform law.

 

OR

 

2.) Healthcare costs and premiums have been on the rise for years; Obamacare actually slows the rate of increase and moderates consumer’s spending on health care.  Cost savings will be recognized with time.

 

Let’s take a closer look at the arguments mentioned above:

 

Obamacare is directly responsible for ongoing increases to consumers’ health care costs.

 

A report released this month (March 2013) by the House Committee on Energy and Commerce credits Obamacare as the driving force in premium increases for young adults and middle-income Americans.  The report claims the Affordable Care Act’s (ACA) mandated reforms  have already and will continue to result in higher costs for insurance companies which are in turn passed on to consumers.   The report cites the following ACA reforms/rules directly increase premiums for consumers:  guaranteed issue and community rating, essential health benefits (EHBs), the individual mandate and fees and taxes on plans, drugs and medical devices.

 

An independent report by Giesla and Carlson (February 2013) reviews the impact of age rating limits established by the ACA, which means older adults can only be charged three times that of a younger adult (currently most states have a ratio of 5:1 or higher).  This report suggests young adults aged 21-29 should expect to pay more for coverage than what they would have without the ACA.

 

Obamacare slows the rate of increase and moderates consumer’s spending on health care.

 

Some analysis claims health care costs have been sky-rocketing for years, not just since the ACA was passed in 2010. A KaiserEDU.org background brief on U.S. Healthcare Costs notes that in the United States health care costs increased significantly from 1980 to 2010, with health expenditures nearing $2.6 trillion in 2010, over 10 times the $256 billion spent in 1980. The report states some major factors in cost growth have been the rise in chronic diseases and administrative costs.  The Kaiser brief acknowledges several ACA measures aimed at cost containment including: greater government oversight and regulation of health insurer premiums and practices, increasing competition and price transparency in the sale of insurance policies through Health Insurance Exchanges, payment reforms that aim to reduce payments for treatments and hospitalizations resulting from errors or poor quality of care, and refocusing medical delivery systems to be  patient-centered and improve the coordination and quality of care.

 

Provisions in the Affordable Care Act used to support the argument that the ACA slows the rate of increase and moderates consumer’s spending on health care include the rate-review provision and the Medical Loss Ratio provision.  The rate-review provision mandates insurance companies must report and justify premium increases over 10%.  Under the Medical Loss Ratio Affordable Care Act provision, insurance companies are required to spend 80% of collected premiums on actual health care. Health and Human Services Secretary Sebelius wrote a blog post about the Medical Loss Ratio provision and how it will save Americans money.

 

Finally, some proponents of the ACA say that while it may be that the expansion of coverage options and higher quality plans of the ACA increase premiums, the emphasis on quality care, case management, and better service will bring overall health care costs down.

 

Conclusions

So, is health reform responsible for premium increases?  We’ll end as we started- it depends on who you ask.  Regardless, whatever facts and studies one choses to rely on to support or negate the impact of health care reform, the Affordable Care Act remains the law of the land.

Thanks to ckfwi.org!

Part-time Workers and the Affordable Care Act

part-time, full time

(photo courtesy of Michael S. Williamson/The Washington Post)

Consumer Reports recently published an article by Nancy Metcalf responding to the question “Will health reform help part-time workers get insurance?”  Here’s a summary of her response:

Though figuring out their access to insurance may not be as simple and straightforward as it is for a full-time employee, part-time or seasonal employees will have access insurance one way or the other, through their employer or through the Marketplace.  Here’s how employers will decide their employee’s eligibility for their insurance: The employer chooses a measurement period (three months to one year) to identify the average number of hours worked by the employee.  If the employee averages 30+ hours per week during that period, he/she will be eligible for the employer-sponsored insurance (ESI).  If the employee averages less than 30 hours/week, he/she will be referred to the Marketplace to access coverage.  The employee will have that coverage for the designated measurement period (three months to one year). After that initial measurement period, the employer will repeat the same process to re-evaluate the employee’s average hours for the next measurement period.  Depending upon the average hours worked, the employee may maintain their current coverage or have to switch.

Here’s an example:

Employer ABC defines the first measurement period from January through June of 2013.  During that time, Shondra averages well over 30 hours a week and is therefore eligible for ABC’s insurance.  During the second measurement period, July through December, Shondra averages only 27 hours per week.  The employer will notify Shondra she is no longer eligible for the ESI, and she will then have to access the Marketplace to shop for a new plan.  Though Shondra may be eligible for tax subsidies to purchase new insurance, the plan’s cost and coverage may be different than the one offered through her employer.

The above example demonstrates that this process may get confusing for part-time employees. Metcalf advises individuals who worry they may be in this situation to connect with their employer and discuss the details.

(Thanks to ckfwi.org for post.)