Now is the time for individuals who are uninsured or are looking for affordable health insurance to investigate the private health insurance plans available through state marketplaces (to find your state information visit the healthcare.gov 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 to people with low and moderate incomes. It is also important for people who currently have insurance through the marketplace to look at the plan to determine if it will continue to meet their needs. 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. To learn more, read The Arc’s blog post. Open enrollment ends on December 15, 2018.
On September 12, the Centers for Medicare and Medicaid Services (CMS) announced grants awarded for the Federally-Facilitated Exchange Navigator Program. Total funding has been reduced to $10 million which is down from $63 million in 2016 and $36 million in 2017. Navigators are charged with assisting consumers in choosing health plans. The administration is also eliminating a requirement that grantees have a physical presence in the area in which they operate. The Administration is also encouraging navigators to inform consumers about association health plans and short-term limited duration health plans, which do not have the protections of the Affordable Care Act. To find the navigator grantees in your state visit this list.
On August 1, the Department of Health and Human Services (HHS) released a final rule regarding the sale of short-term limited duration insurance (STLDI). The final rule changes the duration limit from three months to less than 12 months and allows renewal for up to 36 months. STLDI plans are not required to cover the essential health benefits generally required by the Affordable Care Act (ACA), such as rehabilitative and habilitative services, and mental health and substance abuse services. Furthermore, these plans can deny coverage or charge more because of a pre-existing condition, rescind coverage, and impose lifetime and annual limits. The Arc remains concerned that the expansion of these plans will lead to healthier individuals exiting ACA marketplaces and drive up costs for people who need more comprehensive coverage, such as people with disabilities and chronic health conditions. Read The Arc’s statement here.
On July 26, Representatives Seth Moulton (D-MA) and Gregg Harper (R-MS) introduced the Healthcare Extension and Accessibility for Developmentally Disabled and Underserved Population (HEADs UP) Act of 2018. This bill would declare people with DD a medically underserved population (MUP). People with DD face a shortage of primary care providers, as well as higher infant mortality rates, higher poverty rates, and shorter life expectancy than the general population. The MUP designation comes with increased access to resources from 25 different government programs including Federally Qualified Health Centers, Community Health Centers, loan repayment and training programs under Health Resources and Services Administration Workforce Development and Training Programs, and preference in research within agencies such as the National Institutes of Health. The Arc supports this bill.
The Centers for Medicare and Medicaid Services (CMS) is in the process of distributing newly-designed Medicare cards. As part of the Medicare Access and CHIP Reauthorization Act of 2015, Congress mandated the removal of Social Security numbers from Medicare cards to guard against identity theft. The new cards contain a unique Medicare number for each individual. Cards are being mailed out between April 2018 and April 2019 on a schedule organized by state of residence. Learn more here.
On June 7, the Department of Justice announced that it will not defend key provisions of the Affordable Care Act (ACA) in a lawsuit challenging the law’s constitutionality. The lawsuit filed by Texas and 19 other states, argues that since the Tax Cuts and Jobs Act reduced the penalty for not purchasing insurance to $0, it no longer raises revenue, and is therefore no longer constitutional under the tax powers of Congress. Furthermore, they argue that if the court strikes down the individual mandate, the rest of the ACA must also be struck down. The Department of Justice response argues that the individual mandate is unconstitutional but other provisions of the ACA should remain intact. The Administration further asserts that two critical protections for people with pre-existing conditions, guaranteed issue and community rating provisions, are unenforceable. Guaranteed issue is the provision that prevents denial of coverage based on health status and community rating helps keep insurance affordable for people with health conditions. California and sixteen other states have filed a motion to intervene, which would allow them to defend the law. Peter Berns, CEO of The Arc submitted a declaration in support of California’s motion to intervene. Read The Arc’s statement here.
On May 23, the Congressional Budget Office (CBO) released a report titled “Federal Subsidies for Health Insurance Coverage for People under Age 65: 2018-2028.” The report projects premiums for nongroup marketplace plans to increase by an average of 15 percent. The repeal of the individual mandate to have health insurance that was included in the Tax Cuts and Jobs Act of 2017 is a major contributor to the projected increase. The exit of people with lower health care costs from health insurance markets leads to higher premiums for those who remain. Additionally, enactment of a proposed rule expanding the use of time limited plans could lead to further exits and higher premiums.
On April 9, the Centers for Medicare and Medicaid Services (CMS) released a final rule weakening consumer protections in the Affordable Care Act. The final rule increases the amount by which insurers can increase premiums without regulatory approval, from 10% to 15%. Furthermore, it exempts student health plans from this process. The rule also broadens the circumstances when plans are allowed to spend less than 80% of premiums on providing care without being required to reimburse beneficiaries. Additionally, it allows states to narrow the scope of essential health benefits that plans are required to cover. Learn more about the final rule here.
On January 24, the Senate approved the nomination of Alex Azar to be Secretary of Health and Human Services by a vote of 55-43. HHS is the cabinet level department that administers most federal health and social service programs, including Medicare, Medicaid, Affordable Care Act programs, Developmental Disabilities Act programs, Head Start, and Temporary Assistance for Needy Families. Additionally, it oversees the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health.
On January 17, the Senate Finance Committee voted 15-12 to recommend that the full Senate confirm Alex Azar as Secretary of Health and Human Services (HHS). All Republicans and Senator Tom Carper (D-DE) voted in favor. All other Democrats voted against confirmation. HHS is the cabinet level department that administers most federal health and social service programs, including Medicare, Medicaid, Affordable Care Act programs, Developmental Disabilities Act programs, Head Start, and Temporary Assistance for Needy Families. Additionally, it oversees the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health. Visit the Committee web site for more information or to view archived video of the hearing.