Marketplace
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Let’s Make “SHOP” Work Well for Small Businesses and Families
By Dinah Wiley, CCF Consultant Small business owners and entrepreneurs will have better access to affordable health care plans for themselves and their employees once the Small Business Health Options Program (SHOP) provision of the Affordable Care Act is up and running. This is a great innovation for small businesses as they can pool with…
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High Uninsurance Rate Impacts Access & Quality of Care in Community
We all intuitively know communities are better off when residents have access to health care coverage and a new report sponsored by the Robert Wood Johnson Foundation provides us with even more data to back up that point. The report found that a high rate of uninsurance in a community has a spillover effect for…
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President Obama Unveils Deficit Reduction Plan
Yesterday, President Obama unveiled “Living Within Our Means and Investing in the Future”, a detailed plan that includes $3 trillion in net deficit reduction over ten years. In general, the President’s plan is a balanced and fair approach to deficit reduction. In releasing the package, he sent a stern warning to Congress that he would…
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Let’s Make the Exchanges More Welcoming to All Children and Families
By Dinah Wiley, CCF Consultant Earlier this year, Pulitzer-prize winning journalist Jose Antonio Vargas revealed that he is an “undocumented immigrant”. His mother had sent him from the Philippines to the U.S. at age 12 because she wanted him to have a better life. He was fortunate to have American grandparents and a support network, or…
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Common Sense Standards Would Help Exchanges Be Consumer Friendly
By Joe Touschner The Affordable Insurance Exchanges, as envisioned by the Affordable Care Act, have great potential to help children and families secure quality health coverage that is competitively priced and supported by federal tax credits for those who qualify. As Say Ahhh! readers know, states will operate exchanges under guidelines set by the federal…
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Rising Health Care Costs, Rising Underinsurance
By Martha Heberlein Two studies just out in the September issue of Health Affairs highlight the troubles many face in affording health care coverage. The first study by researchers at the Commonwealth Fund found that over the past 7 years the number of people who had coverage year-round, but were considered “underinsured” rose by 80%. (The authors…
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Momentum Builds as Diverse Group of States Receive Exchange Establishment Grants
By Joe Touschner In addition to the package of proposed rules it released on August 12, HHS also announced the award of more than $185 million in grants to help states develop their exchanges. The federal funds will support state efforts to strengthen information technology systems, analyze insurance markets, develop consumer assistance capacity, and design…
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New Transparency Rules Will Help Consumers Compare Health Insurance Plans
We got some good news last week from the Administration – new rules for individual and group health plans that require them to disclose critical information about their benefits and out-of-pocket costs. For many of us, this is sort of “ho-hum” news because our employer pretty much makes the decisions about what health plan to…
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ACA Propels States to Adopt Best Practices in Simplification and Alignment
and Jennifer Mezey, National Women’s Law Center Simplification and alignment of policies for children in Medicaid and CHIP have helped states fill the gap in private insurance and achieve record levels of coverage for 90% of our nation’s children. These lessons are carried forward in the Affordable Care Act’s (ACA) expansion of coverage through Medicaid…
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Affordable Care Act Preventive Services are Good News for Women and Children
By Jennifer Mezey, National Women’s Law Center In a significant victory for women and girls, the US Department of Health and Human Services announced this week that all new insurance plans would be required to cover a wide range of preventive services aimed at women’s health – without cost sharing — starting in the first…
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Proposed Rules Fast-track State Efforts in Streamlining and Coordinating Coverage for Children and Families under the ACA
Successful state strategies in streamlining eligibility and coordinating enrollment in Medicaid and CHIP are the heart and soul of the latest round of proposed regulations issued for the Affordable Care Act (ACA). While we’re still wading through the three sets of proposed rules released today by CMS, it’s clear that these regulations take a number…
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CMS Offers a Sweeter Deal in Trading Up Integrated Eligibility Systems
Even if you tend to gloss over my technology blogs, please keep reading because this is really BIG news for the states. Yesterday, CMS announced that, for a limited time, it is waiving the requirement that the cost to replace or improve integrated eligibility systems be allocated across programs (at each program’s matching rate). Let’s…
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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…