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Celebrating Moms

MH900434601Today’s post comes from guest blogger Maryanne Tomazic, Field Coordinator at Raising Women’s Voices.

When the New York Health Benefit Exchange opens for enrollment this October, we know it’s going to be especially important to reach out to mothers. They play a huge role in our families’ health, as they often are the decision makers and coordinators of care for our families. They should be armed with information on how to get health insurance that provides care to our families, without breaking the bank.

On Sunday, May 19th, from 11 to 5, Health Care for All New York will be at the Mamapalooza Festival in Riverside Park, Manhattan (entrance at West 68th and the Hudson River). Stop by our table where you can get more information about how the health care law helps moms and our families get the care they need to get and stay healthy. We’ll also have information about some of the new coverage options coming this fall, and how you can sign up for more information. We’ll have some great giveaways too – for both moms and kids – so be sure to swing by!

Can’t wait till then? Join us on Twitter today (@hcfany) and follow the hashtag #mamasays. We and health care advocates across the country will be tweeting tips that #mamasays about your health and invite you to do the same!

Happy Birthday, Baby!!

Happy Birthday!

Tomorrow marks the 3-year anniversary of the ACA and  – wow – what a journey it has been! 

 Despite its youth, the ACA has already succeeded in helping millions of Americans get access to affordable care.  For example, children with pre-existing health problems can no longer be turned down for coverage. Small businesses have access to tax credits to help pay for health insurance for their employees: 4 in 5 New York small businesses are eligible.  Preventive care is now available without co-pays, seniors who hit the Medicare “donut hole” are paying less for prescription drugs, and health insurers now have strict guidelines on how much of your monthly premium must be used on medical care rather than their own administrative costs.

 A few numbers give a picture of just how much the ACA has helped people in our state:

  • New Yorkers with Medicare have saved over $407.6 million on prescription drugs since the law’s enactment.  In 2012 alone, 226,569 individuals in New York saved over $170.4 million, or an average of $752 per beneficiary.
  • 4.4 million New Yorkers gained access to free preventive health services in 2011 and 2012.  1.5 million seniors with Medicare received free preventive health care in 2012 alone.
  • This year, 1 million New Yorkers with private insurance coverage will get $86,526,642 in rebates from insurance companies who have overcharged them, with an average rebate of $138 per family.

 And the best is yet to come:  In 2014, annual limits on insurance coverage will be banned, adults with  pre-existing conditions will no longer be denied coverage,  and tax credits will be available to help individuals and families pay for health insurance.  And, individuals and small businesses will be able to get health insurance, including public programs like Medicaid, through the New York Health Benefit Exchange.  This will save New Yorkers who buy insurance on their own an average of over 60% and people who get it through their small business over 20%. Enrollment will begin October of this year!

 Because of the ACA, affordable, quality health care will soon be woven into the fabric of American society, making us stronger and healthier as a nation.  And that’s something we can ALL look forward to!

 So, Happy Third Birthday, ACA!  May you live a long, happy (and healthy) life!

 

Dear Gov. Cuomo & Legislature: You’ve Got Mail!

You've got mail!

HCFANY is happy to report that our letter to Governor Cuomo and the NYS Legislature on the budget’s elimination of the Family Health Plus program and out-of-network benefits on the individual market has been delivered!

The letter was actually hand-delivered around the capitol early this afternoon, and sent out to the press shortly thereafter.  Thanks to everyone who signed on – at final count we had 37 groups listed!  You can view the final letter sent by clicking here.

It looks like the budget will be closing down this weekend, but there is still time to make phone calls!  Call your legislators today and tell them to protect low-income families and New Yorkers with special health needs by providing a solution to the elimination of the Family Health Plus program that would treat all consumers equally, regardless of family composition, and provide additional subsidies to all eligible consumers up to 150% of FPL, and to preserve the requirement that insurers offer consumers on the individual market the option of out-of network care.

We can do this!!!

 

Do YOU understand the new coverage choices under the ACA?

Coverage choices

Thanks to the Affordable Care Act (ACA), more than 1 million uninsured  New Yorkers will newly have access to affordable health insurance options starting this fall.  That’s a lot of folks who will need to wade through a lot of new information in the coming months.

HCFANY will be holding a briefing in New York City on Thursday, March 7th at the Interchurch Center from 9:00 am – 11:30 am to go over the necessary public outreach and enrollment efforts that will need to happen in order to ensure that the greatest number of New Yorkers benefit from the ACA.  Specifically, we will be going over the following questions:

  • How will New Yorkers learn about new health coverage options?
  • How is New York State going to reach out to and sign up the uninsured?
  • What will individuals, families, and small employers in New York l need to know?
  • What’s to be gained if we do it all right  (…and at risk if we don’t)?
  • What can our elected officials do to help make it go smoothly?
  • How can groups across New York contribute and participate?

This meeting is open to all New York members, allies, colleagues and new friends in the NYC area.

For more information, or to RSVP, click here!

 

I checked…and I’m covered with no co-pays!

 Be mine!

 

RWV’s New York intern, Nina Nnamani, shares what she learned about how the Affordable Care Act (ACA) has improved her health insurance coverage.

Nina Nnamani of RWVAs a woman in her early 20s, I am among those who benefit most from the health care law. I am in my first year of graduate school and have a lot of things on my “worry list” – assignments that must be turned in, rent that is due, loans that must be paid back and more. However, thanks to the new health care law, affording co-pays for key preventive care isn’t one of my worries.

Under the law, all new insurance plans must cover key preventive care for women without copays. This means that care like birth control or screenings for sexually transmitted infections are provided at no extra cost.

I knew this provision applied to plans starting after August 2012, and that many women would see the changes go into effect in January 2013 (when many new plan years start). But, I didn’t know whether my plan was complying and whether I’d begin seeing coverage without co-pays too.

Well, I checked, and it does! This is the first year that I will be able to get this key preventive care without paying for extra costs. This helps me stay healthy while on a student budget, and allows me to cross one more thing off of my “worry list.”

This provision of the health care law applies to all new plans starting on or after August 2012 (with an exemption for certain religious institutions). Check to see if you are covered too! Ask these questions to find out whether your plan is complying.

***

HAPPY VALENTINE‘S DAY!

 

 

Don’t leave New York’s low-income families out in the cold!

Baby, it's cold outside!

The Governor’s proposed 2013-2014 Executive Budget aims to get rid of New York’s Family Health Plus (FHP) program by closing off enrollment by the end of this year.  Enrollees who earn below 138% of FPL (about $26,000 per year for a family of three) will get the current Medicaid benefit (with the exception of long-term care).  Parents up to 150% of FPL (about $28,000 for a family of three) will get subsidized coverage on the forthcoming Exchange.

However, eligible folks who aren’t able to enroll by the cutoff date, or whose income shifts into the eligible range after the cutoff date will be out of luck.  These folks will have to look for affordable coverage on the Exchange.

The Exchange will provide premium tax credits to help lower the cost of insurance for most low- and moderate-income folks who purchase coverage on the Exchange.  But, it will still be too expensive for many families.  For example, a family of three earning 150% of FPL will still have to come up woth $1,099 per year on their own for coverage on the Exchange whereas the same family would have gotten free coverage with very low cost-sharing through FHP.

But there is a solution to this affordability problem.

  • First, we ask the State to apply for an 1115 waiver – similar to those being pursued by Massachusetts and Vermont – to provide an affordability wrap for premiums and cost sharing for folks up to 200% of FPL not eligible for Medicaid.  This would help to get out-of-pocket costs on the Exchange down as close as possible to FHP levels. If NY can’t get federal matching funds, the State should earmark a portion of the $2.5 billion in State Medicaid savings under the ACA for this.
  • Next, New York should lay the foundation for a Basic Health Plan (BHP) by authorizing establishment of this program starting in 2015.  The ACA gives states the option of creating a federally-funded BHP to cover adults up to 200% of FPL not eligible for Medicaid.  This program would result in State savings of between $500 million and $1 billion each year.

This is a big opportunity for State lawmakers to ensure affordable coverage is available to the individuals and families who need it most.  And, when federal funds or state savings are factored in, it would require little or no additional cost to the State.

Quite simply, it’s the right thing to do.

 

 

The Basic Health Plan sounds like the right choice

The choice is pretty darn clear

Under the ACA, states are allowed the option of creating a Basic Health Plan (BHP) for low-income adults who earn too much to qualify for Medicaid.  Ordinarily, if these folks don’t have employer-sponsored coverage then come 2014 they will be able to buy insurance through the Exchange with the help of federal tax credits.  But, even with the tax credits this coverage may still be too expensive for them. The BHP then would act as a bridge between the free or low-cost Medicaid coverage and the higher priced options available on the Exchange.

Don’t be fooled by the name though - there is nothing “basic” about it.  According to the ACA, BHP coverage must be as affordable and comprehensive as what these adults would have gotten on the Exchange.  In New York, coverage would likely resemble that of the Family Health Plus program.

New York currently offers public coverage to low-income adults through its Family Health Plus program, the cost of which is split with the federal government.  New York also pays for Medicaid coverage for low-income immigrants without help from the federal government.  Through the BHP program, New York would be able to cover both of these groups and have the federal government pay for it all.  This would save the state between $500 million and $1 billion per year.

Sounds great, right? Problem is, the federal government still hasn’t released guidance on this program, and isn’t planning on doing so anytime soon.  Unfortunately, state policymakers won’t commit to the program until they are sure of all the details.  So, until that happens, it is unlikely that New York will get any of the cost-savings and affordability protections that the BHP has to offer.

HCFANY has created a policy brief on this issue to explain it in detail, urge federal policymakers to release BHP guidance, and provide recommendations to state policymakers. 

Click here to read HCFANY’s policy brief, titled “The Basic Health Program Option in the Affordable Care Act.”

 

The importance of getting the word out

Listen up!

Implementation of New York’s health benefit Exchange is now well underway, and policymakers are estimating that over one million New Yorkers will enroll in some form of health insurance through the Exchange.  Yet, the vast majority of New Yorkers still don’t understand what the Exchange is or what it will do.  Many others have not even heard about it yet.

With the Exchange set to start accepting enrollment applications in October of this year, it is quickly becoming clear that the State is in dire need of a public engagement campaign. 

What it boils down to is that there are currently around 2.8 million New Yorkers who are uninsured.  The Exchange is, above all, being created so that these folks will be able to find and enroll into quality, affordable health coverage.  But, how can the State policymakers who are designing and implementing the Exchange know that they are building a system that will work for New York’s uninsured, without actually asking them about it?

At the same time, in order the reach its goal of getting one milion New Yorkers enrolled through the Exchange, the State will have to find a way to get these one million New Yorkers informed about the Exchange, motivated to pursue coverage through it, and able to use the system. 

That’s a lot to accomplish in just 8 months!

HCFANY has put together a short policy brief on this issue, with recommendations for State policymakers on how to get the public engaged and informed about the NYS Exchange.

Click here to read the HCFANY policy brief titled “Reaching One Million More New Yorkers: A Successfulc Enrollment Campaign for the Exchange.”

 

 

Update on the NYS Health Benefit Exchange

Yesterday, the NYS Exchange hosted a webinar briefing for members of the State’s Regional Advisory Committees.  The webinar provides an update and timeline on the forthcoming health plan invitations to participate in the Exchange, and the Navigator program.

The presentation also includes a draft of the standard plan designs that will be offered on the Exchange for individual coverage so you can see the differences in the “precious metal” product tiers and cost-sharing associated with each.

Click here to view the presentation slides.

A new year, a new round of goodies from the ACA

For you!

A lot of folks think that 2014 is when the Affordable Care Act will really kick into effect, and yes, that is when the health insurance Exchanges will become fully operational.  And yes, those are a big part of the ACA.  But, they’re not the whole thing!

Many great things have already happened in the years since the law was implemented, including small business tax credits, a new coverage option for uninsured folks with pre-existing conditions, free preventive care, and allowing young people to stay on their parents’ plan until the age of 26.

And, 2013 will be no exception! There are more good things in store for us this year.  Here is a roundup of some of what’s to come:

  • More subsidies for seniors who hit the donut hole:  Seniors who hit the Medicare Part D coverage gap will now get federal subsidies for brand-name prescriptions (in addition to the 50% manufacturer brand-name discount that went into effect in 2011).
  • Improving Preventive Care:  State Medicaid programs that offer free or low cost preventive services will get increased federal funding to do so.  This means that low-income folks in many states will have better access to vaccinations, tests like colonoscopies and mammograms and routine screenings for high blood pressure, diabetes, and cholesterol.  
  • Increased Medicaid payments to doctors: On January 1st, Medicaid payments for primary care doctors were brought up to Medicare levels. In New York, this will mean an estimated increase of 156% in Medicaid payments to doctors and will help to ensure low-income New Yorkers have sufficient access to doctors.  For more info on this, check out the Kaiser Family Foundation report titled, “How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees”
  • CHIP funding will be extended: the ACA will authorize funding for the Children’s Health Insurance Program (CHIP) through 2015 (extended from 2013).  In New York, this program is called Child Health Plus. This will allow roughly 400,000 kids in New York to keep their free or low-cost health insurance.   

Of course, not all of the ACA changes happening in 2013 will be a clear-cut “goody.”  2013 will also see a number of tax changes, including an increase in Medicare taxes for higher income earners (in order to boost up the Medicare trust), an exise tax of 2.3% on the sale of medical devices, and changes to FSA limits.  For a full list of changes, check out the Kaiser Family Foundation’s Implementation timeline.

 

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