The U. S. Supreme Court upheld the Affordable Care Act (ACA) again in deciding King v. Burwell. The justices, in a 6-3 ruling, said that Congress intended for federal subsidies to be available in every state, regardless of whether the state created its own marketplace. The Arc applauded the decision as a major victory for people with disabilities and others who need access to affordable health care.
The ACA is important to people with disabilities. It expanded coverage and reformed insurance to end discrimination against people with disabilities and enhance access to health care. The private health insurance marketplaces allow individuals or small businesses to shop for coverage and potentially receive subsidies to help offset the cost of insurance. The subsidies are key to ensuring affordable coverage. The health insurance reforms, the protections from high premium increases or out-of-pocket costs, and the coverage of “essential health benefits”, including mental health care and rehabilitative/habilitative services and devices, help assure that people with disabilities have affordable health care that meets their needs. To read The Arc’s statement visit our blog.
The Senate overwhelmingly approved a permanent fix to the reimbursement rates for Medicare providers, sending the measure to be signed by President Obama. If Congress had not acted, Medicare health care providers faced a 21% cut to their reimbursement. In addition to permanently fixing the reimbursement problem, the legislation extends the Children’s Health Insurance Program for two years, and extends the therapy cap exceptions process. Senator Ben Cardin (D-MD) offered an amendment to eliminate the therapy caps. The amendment failed by two votes to reach the 60 vote threshold needed to be included in the legislation. The bill also permanently extends the Qualified Individual (QI) program under the Medicare program, which helps low-income Medicare beneficiaries pay for premiums and permanently extends the Transitional Medical Assistance (TMA) program, which helps families on Medicaid maintain their coverage for one year as they transition from welfare to work.
By an overwhelming margin, the House passed H.R. 2, the Medicare Access and Chip Reauthorization Act, which would change the way Medicare reimburses physicians and would extend funding for the Children’s Health Insurance Program (CHIP) for two years. The bipartisan bill passed 392-37. The Senate is planning to take up the measure when it returns in two weeks. If Congress does not act, Medicare providers face a 21% cut in their reimbursement for medical care provided to eligible Medicare beneficiaries. The bill also would make permanent a program to help low income Medicare beneficiaries pay for premiums and would permanently expand a Medicaid provision that helps families on Medicaid maintain their coverage for one year as they transition from temporary assistance to work. The bill also would extend the therapy cap exceptions process and the Family –to-Family Health Information Centers for two years. The Arc supports making these provisions permanent as well as a longer extension of CHIP.
Open enrollment for health insurance offered through the marketplaces ended February 15, 2015. Extra time is allowed for people who started the enrollment process but did not finish. There are also special enrollment periods for people who lose their health coverage or experience another qualifying change in their situation. The administration is reporting that 11.4 million people signed up or were re-enrolled for health insurance during the open enrollment period. For more information about health insurance visit: https://www.healthcare.gov.
Open enrollment for health insurance marketplaces under the Affordable Care Act ends February 15. This is an opportunity for people who do not have health insurance to purchase it. There is also help with paying the costs of health insurance for low and moderate income individuals. To learn more about what is available in your state visit the health care website.
Last week, new fact sheets were released for the National Disability Navigator Resource Collaborative (NDNRC). These latest installments are part of a series that will help health care assistors with information they need to help specific populations within the disability community chose an appropriate health care plan. Previously released fact sheets include information on Autism, Intellectual Disability, Multiple Sclerosis, Mental Illness and Veterans Affairs. In addition, educational webinars will be offered on a variety of topics. The Arc is a participating organization with the NDNRC. For additional information visit the NDNRC website.
On November 14, the White House released a new public service announcement on the Affordable Care Act and people with disabilities. It explains how individuals with disabilities can no longer be denied health coverage because of health history. The public service announcement was released to coincide with open enrollment, which began on Saturday, November 15, and ends on February 15. This time period will be a chance for individuals already enrolled in healthcare to re-enroll and for individuals not yet enrolled to sign up to begin receiving healthcare. To see the new announcement view it on The White House YouTube page. For additional information on coverage, please visit www.healthcare.gov.
On Sept 19, The Department of Defense’s TRICARE program published its new Autism Care Demonstration guidance. While the program includes several improvements, it also includes a nearly 50% reduction of reimbursement rates for board certified behavior analyst (BCBA) delivered therapy and more. The program was subsequently launched on Oct. 20; however, after strong opposition from advocates, the BCBA reimbursement policy has been delayed by 180 days. Learn more at Autism Speaks.
Now is the time for individuals who are uninsured or looking for affordable health insurance to investigate the private health insurance plans available through state marketplaces (to find your state information visit the health care website. During “open enrollment”, a person can purchase private health insurance through the marketplace in each state. There may also be financial assistance to help with health care costs available for low and moderate income. It is also important for people who currently have insurance through the marketplace, to look at the plan and determine if it will continue to meet the needs of the person, or select a better plan. Individuals who do not take action will be automatically re-enrolled in the current plan. Re-enrollment is also an important opportunity for people to report any changes in income.
2015 Open Enrollment
November 15, 2014 – Open enrollment begins
December 15, 2014 – Enroll before this date to have coverage January 1, 2015
February 15, 2015 – Open enrollment ends
For more information and where to get help, read more on The Arc’s blog.
The Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2014 was signed into law on August 8, 2014 by President Obama. This bipartisan legislation, introduced by Senators Robert Menendez (D-NJ) and Mike Enzi (R-WY) and Representatives Chris Smith (R-NJ) and Mike Doyle (D-PA), reauthorizes the Combating Autism Act of 2011 for an additional five years and makes a number of improvements to it. Since its original enactment in 2006, the law has significantly advanced the science and practice in the disability field by increasing the number, scope, pace, and coordination of research, surveillance, public awareness, and professional training efforts. This has resulted in an increase in the proportion of infants screened for autism spectrum disorder (ASD), an increase in the proportion of children diagnosed by the age of three, and continuing improvements to decrease the time between diagnosis and intervention. The new law continues these efforts and makes the following improvements – a name change that uses more respectful language, a designated ASD position in the Department of Health and Human Services to oversee the law’s implementation, increased representation of self-advocates and family members on the Interagency Autism Coordinating Committee (IACC), and requiring a report on the needs of transitioning youth.For more information on the accomplishments of the prior legislation see, “Report to Congress on Activities Related to Autism Spectrum Disorders and Other Developmental Disabilities Under the Combating Autism Act of 2006 and Combating Autism Reauthorization Act of 2011 (FY 2010-FY 2012)”.