Marketplace
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Health Reform is Working – Proof is in the Family Stories
By Jeff Tieman, Catholic Health Association Bryce Dixon, a 24-year old dairy farmer in Cosby, Missouri near the Kansas border, suffers from ankylosing spondylitis, a type of arthritis that primarily affects the spine. This condition causes debilitating swelling of the joints and feet, as well as autoimmune deficiencies. Bryce requires twice monthly injections of a…
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Time Is Ripe for Advocates to Weigh In on Exchanges
By Joel Ferber, Legal Services of Eastern Missouri One of the most important ways that the Affordable Care Act (ACA) will improve insurance coverage for Americans is through the development of state health insurance exchanges. So far in 2011, ten states have enacted legislation to set up a state-based exchange while eight others have passed…
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Converting to MAGI, What Does It Really Mean for Kids?
One of the more mystical sounding acronyms receiving a lot of attention in the Affordable Care Act (ACA) is MAGI or Modified Adjusted Gross Income. MAGI is a way of defining income rooted in tax law and, along with the size of the tax filing unit (to determine household size), will be used to evaluate…
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Keeping on Track: California Continues to Move Forward on Health Insurance Exchange
(Editor’s Note: In an effort to keep our readers up to speed on what’s happening on the development of state-based health insurance exchanges, we are checking in periodically with states that are moving forward. This month, we visit our friends in sunny California.) By Nicette Short (Children Now) and Kathleen Hamilton (The Children’s Partnership) on…
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When Can States Impose Copayments for Non-Emergency Use of ERs?
By Wesley Prater We have been hearing that more states are looking to use copayments to deter non-emergency use of the emergency room for low-income families, so it’s probably a good idea to discuss what the federal rules are and how some states have already been dealing with this issue. In an effort to try…
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Medicaid has Responded Successfully to Economic Downturn
By Tara Mancini As our readers know, Medicaid is a public insurance program financed jointly by states and the federal government to assist low-income individuals and families in obtaining health insurance. Using state specific formulas known as FMAP, the federal government provides at least $1 in matching funds for every $1 spent by states. During…
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HHS Proposes Initial Exchange Rules
By Joe Touschner Since the passage of the Affordable Care Act, we’ve known that state exchanges are a big part of the vision for reforming and expanding health coverage. Although that vision may have started about a bit hazy, it’s coming into sharper focus. State policymakers have been passing laws and taking other action to…
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Appeals Court Rules Affordable Care Act Constitutional
This week, the Sixth Circuit Court of Appeals upheld the Affordable Care Act as constitutional (including the key individual responsibility provision) infusing a large dose of rational thinking into the highly polarized world that surrounds the health reform law. In fact, the majority opinion used the word “rational” several times in rejecting the challenge by…
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Blended Match Rate Proposal Raises Red Flags
By Jocelyn Guyer Last week just as Representative Cantor was making his dramatic exit from deficit reduction talks with Vice President Biden, rumors started to emerge that the idea of adopting a “blended matching rate” for Medicaid and CHIP was gaining currency. The Obama Administration first put forth the idea in a deficit reduction proposal…
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KidsWell Campaign Launches Online Resource for Health Reform Implementation
By Kimberley Chin, Programme Executive, Atlantic Philanthropies State advocates face enormous challenges–shrinking resources, entrenched politics, an often disinterested press. Yet somehow, we manage to get it done.Just about every major federal policy initiative begins and ends at the state.It was the states that conceived of what became CHIP, launched the first health benefit exchanges with…
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A Disappointing Rollback of Consumer Protections on Appeals
Imagine you’re a parent and your child has been diagnosed with cancer and is going through painful, debilitating treatment. You can imagine the sleepless nights, the worry, the exhaustion, the fear. Now imagine that your insurance company denies some of the claims for your child’s treatment – treatment that the doctors assure you are essential…
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Exchange Implementation Work Underway Across the Country
By Joe Touschner Don’t believe everything you read in the newspaper — while the national media has reported that states are moving “gingerly” to implement the Affordable Care Act, in fact there’s been a great deal of activity of late, especially around exchanges. No fewer than 16 state legislatures have acted favorably on measures that…
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It Can Be Complicated to Be A Kid
By Martha Heberlein Health reform creates many new options for children and families to secure coverage; however, as more options become available, children may face more complex coverage arrangements. In fact, recent estimates suggest that 20 million children live in situations that may make accessing coverage challenging due to differing eligibility status within their families. As…
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Out of the Shadows: Exchange/Medicaid IT 2.0 Guidance Says No Need for Duplicate Eligibility Systems
In this week’s release of the Exchange/Medicaid IT 2.0 guidance, the Centers for Medicaid and Medicare Services (CMS) firmly squashed speculation that states will need to operate a “shadow eligibility system” for determining who is newly eligible for Medicaid and therefore qualifies for 100% federal funding. Future federal rulemaking is expected to propose other methods…
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Three States Move to Next Phase of Building their Health Benefits Exchanges
This week, the Department of Health and Human Services (HHS) awarded the first round of grants to help states establish health insurance exchanges. State officials in Washington, Indiana and Rhode Island were granted a total of $35 million to begin building their exchanges. In announcing the grants HHS said that the states “will use the…
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Affordable Care Act Protecting Consumers from Premium Spikes
Health insurance premiums and gas prices have one thing in common – they are both rising at a time when oil and insurance companies are earning record profits. Most of us can figure out ways to cutback on our energy consumption to reduce our expenditures at the gas pump but cutting back on health care…
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Arkansas Lawmakers Ensure Kids Keep Coverage as Private Plans Leave the State
By Elisabeth Wright Burak, Arkansas Advocates The legislative session in Arkansas ended last month with many accomplishments for kids’ health on the books. We spend a lot of time talking about measures to improve access to ARKids First and promising new oral health accomplishments, including better availability of fluoridated water and preventive dental services. …
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Keeping Up with the California Health Benefit Exchange Board: Starting Off On the Fast Track
By Nicette Short of Children Now and Kathleen Hamilton of The Children’s Partnership California’s Health Benefit Exchange Board, created under the Affordable Care Act, held its inaugural meeting on April 20, 2011 in Sacramento, California. Even with one of the five Board seats vacant (the California Senate has not yet selected its appointee), the California…
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Oklahoma Makes U-Turn and Rejects Early Innovator Grant
By David Blatt, Director of Oklahoma Policy Institute In the new national health care law (the Affordable Care Act, or ACA), exchanges are state-level competitive marketplaces for individuals and small businesses to purchase insurance. After winning a $54 million Early Innovator grant earlier this year, Oklahoma was poised to become a national leader with a…
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Presumptive Eligibility: Providing Access to Health Care Without Delay and Connecting Children to Coverage
Presumptive eligibility is a state policy option that gives states the flexibility to train health care providers, schools and other community-based organizations and programs to screen eligibility and temporarily enroll eligible persons in Medicaid and CHIP. Currently 31 states use presumptive eligibility for pregnant women and 16 states enroll children presumptively. The following issue brief…