As Year 3 of Affordable Care Act (ACA) enrollment quickly approaches, we can look to experienced assisters to figure out how to best plan for a successful year. During the first two years of open enrollment, Illinois had a large cadre of in-person assi…
This blog post was coauthored by the Center for Children and Families of the Georgetown University Health Policy Institute.
In the coming weeks, the Supreme Court will rule on King v. Burwell (King), a case that could have far-reaching effects on heal…
The deadline for California Assembly and Senate bills to pass their respected houses was May 30, 2014. Bills that met the deadline are eligible for enactment this year.
Bills that met the May 30 deadline will now be considered by the opposing house, wi…
Federal officials recently approved “reference pricing,” a new cost-control mechanism that allows insurers to put a dollar limit on the amount that health plans pay for some expensive medical procedures, such as knee and hip replacements.&n…
By Peter Felsenfeld
More than a million California residents whose health plans were cancelled under the Affordable Care Act, a.k.a. Obamacare, will not be able to keep their existing coverage, despite President Obama’s directive that insurers k…
You have probably heard a lot of negativity recently about the Affordable Care Act (also known as the ACA or Obamacare). Website glitches, trouble registering, cancelled policies, OH MY!
In this negativity cloud, it’s easy to miss really big, goo…
It’s October 1, 2013. Lots going on—or not, since many parts of the federal government are shut down.
But it is a very big day for the 48 million uninsured Americans who need health insurance coverage. It’s opening day for the health …
Illinois took a big step on the road toward all Illinoisans having quality, affordable health care this past week. On July 22, 2013, Illinois Governor Pat Quinn signed into law Senate Bill 26, as Public Act 98-0104. The new law extends Medicaid eligibility to nearly all low-income Illinois residents effective January 1, 2014. Until now, low-income adults, ages 19 through 65, the great majority of whom are working at lower wage/no benefits jobs, have not been eligible for Medicaid. These people qualified only if they were totally disabled or caring for minor children. The federal Affordable Care Act allows states to cover this long left-out group in their Medicaid programs and receive 100% federal funding for the costs. With Public Act 98-0104, Illinois wisely is doing so.
With the other ACA reforms also set to go into effect January 1, 2014, nearly all uninsured Illinois residents now will have access to public or private health coverage and health care. Those under 138% of the Federal Poverty Level (FPL) ($15,415 for an individual) will be eligible for public coverage in Medicaid. (The income limits are higher for children in Illinois’s All Kids program.) Those over 138% of the FPL will be able to purchase health insurance on the Illinois Health Insurance Marketplace. Illinoisans finally will have peace of mind knowing that:
- they can get comprehensive, affordable private insurance if their income is over Medicaid’s limits;
- they can get Medicaid if their income is lower;
- they can move from public to private health coverage and vice-versa as their income changes; and
- both the private insurance plans and Medicaid will cover comprehensive, quality care.
The insurance sold on the Marketplace starting October 1, 2013, will be better in coverage and cost than the individually purchased health insurance now being sold. ACA reforms eliminate insurance companies’ ability to deny or price coverage based on one’s preexisting medical condition or gender. Instead, health insurance policies will be priced on the basis of the customer’s age, geography, number in family, and tobacco usage. Additionally, policies must cover a broad range of needed health services and not charge any copayments or deductibles for preventive care.
Medicaid, too, will offer comprehensive, quality coverage. Skeptics (and there are a lot of them) who disparage Medicaid coverage should take another look. The Illinois Medicaid program has been reforming itself for several years now. It was ahead of the curve on requiring Medicaid patients to have a “medical home,” that is, a primary care doctor who manages their care and refers them for specialty care as needed. It also is testing a variety of “care coordination” models that take the medical home concepts farther and, through provider payment methods aimed at improving quality and decreasing costs, encourage preventive care, discourage unnecessary emergency room use, and support patient follow up and follow through on treatment.
With the enactment of Public Act 98-0104, Illinois is a lot closer to coverage for all. On January 1, 2014 (with enrollment starting October 1, 2013), Illinois residents at all income levels will have access to quality, affordable health insurance coverage. Of course, neither Medicaid coverage nor insurance coverage will drop from the sky. People need to apply. They can do that starting October 1. Between now and then the Illinois government, the federal government, and hundreds of Illinois community groups will be offering information about public and private coverage and the application process. And after October 1, they’ll be there to help us apply and walk us through the enrollment process.
On Tuesday, July 2, 2013, the U.S. Department of Treasury announced that it will provide an additional year before the mandatory employer and insurer reporting requirements of the Affordable Care Act (ACA) begin.
In a blog posting, Mark J. Mazur, Assistant Secretary for Tax Policy at the U.S. Department of Treasury, stated that the Administration has been engaging in a dialogue with businesses about the new reporting requirements under the ACA.
According to Mr. Mazur, “[w]e have heard concerns about the complexity of the requirements and the need for more time to implement them effectively.”
The additional year will meet two goals, according to Mazur:
First, it will allow us to consider ways to simplify the new reporting requirements consistent with the law. Second it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees.”
UnitedHealth recently announced that it will be leaving California’s individual health market at the end of this year.
UnitedHealth’s announcement comes on the heels of a similar announcement by Aetna last month. Both UnitedHealth and Aetna will…