Affordable Care Act: Key Provisions for People with MS

Size: px
Start display at page:

Download "Affordable Care Act: Key Provisions for People with MS"

Transcription

1 Affordable Care Act: Key Provisions for People with MS October 2013

2 Why reform healthcare? By 2008, 15% of the U.S. population, or approximately 47 million Americans, lacked health insurance Documented link between lack of insurance and bankruptcy, death, barrier to global economy, perception the system was unfair The United States is spending more per capita than other nations, yet health status is significantly worse Healthcare costs double every 10 years; amounts to 17% of GDP Significant evidence that much of healthcare is ineffective, wasteful, or even harmful The Dartmouth Atlas Project shows wide, inexplicable variations in cost of the same services across the U.S. Growing consensus among public, employers, and the medical community that the current system is unsustainable

3 Quick Facts Historically, many people with MS faced challenges in finding and keeping adequate, affordable health coverage. Coverage (Iezonni, 2007) Cost (Minden, 2006, 2008) People with MS are more likely to be unemployed. 30% of those with MS put off seeking health care because of costs. 20% of people living with MS could not fill prescriptions or skipped doses because did not have access. The average annual cost of living with MS is approximately $70,000. The average lifetime cost of living with MS is approximately $2 million. Out-of-pocket costs for health care among people with MS (deductibles, copay, co-insurance) os almost twice as much as the general population.

4 Primary Source of Coverage for People with MS Before the Affordable Care Act Insurance for People with MS 4% 5% 4% 20% 9% 56% Private Insurance Medicare Medicaid Medicare & Medicaid Uninsured Other Source: Iezzoni & Ngo. Health, disability and life insurance experiences of working-age persons with multiple sclerosis. Multiple Sclerosis 2007; 13:

5 National MS Society takes a principled position Principles for Health Care Reform Accessible health care coverage Affordable health care services and coverage Standards of coverage for specific treatments Elimination of disparities in care Comprehensive, quality health care for all Increased value of health coverage Access to high-quality, long-term supports and services

6 Key Provisions Will Improve Lives of Those Living with MS Provisions ACCESS for those with pre-existing conditions AFFORDABLE coverage and care ADEQUACY of Benefits Description Phase-in of prohibition on coverage denials based on pre-existing conditions began with special high-risk pool until 2014, AND prohibition on denials for children (up to age 19) with pre-existing condition. In 2014, prohibits discriminating for pre-existing conditions. Ban on rescissions took effect immediately (2010). Lifetime caps on benefits prohibited, annual caps limited. Premium credits up to 400% of the Federal Poverty Level (FPL). Out-of-pocket costs limited. Medicaid expansion to 133% FPL. (22 states so far) All qualified health plans must cover essential health benefits -- at least. Preventive health benefits covered with no deductibles or co-pays in public and private health coverage. Coverage of costs for care in clinical trials.

7 ACA Improves Private Health Insurance Private Insurance Provision Effective date Prohibits discrimination based on pre-existing conditions in all plans Children: 2012 Adults: 2014 Guaranteed renewal of insurance policies Effective 2014 Prohibits use of rescissions except for fraud or non-payment Effective 2010 Premiums subsidized through tax credits for all at/below 400% Federal Poverty Level (FPL) Limits out-of-pocket costs for all plans sold in the exchange (approx. $6250 for individuals and $12,500 for families in 2014) Effective 2014 Effective 2014 Bans lifetime benefit caps; restricts annual benefit caps Effective 2011

8 ACA and Medicare: reducing costs, expanding benefits, rewarding quality Medicare Provision No cost-sharing for evidence-based preventive services, annual wellness visit and personalized prevention plan New demonstration programs to help ID best ways to reward the quality of care rather than the quantity of care Effective date Effective 2011 Phased in from 2012 Medicare Rx coverage gap phases out by 2020 In 2010, $250 rebate Starting 2011, brand name drugs cost 50% less during coverage gap Gap gets smaller until 2020 then beneficiaries pay 25% of drug costs all year Phased in from 2010

9 ACA Expands, Improves Medicaid Medicaid Provision Income eligibility becomes standardized (133% FPL) in states that choose to expand Medicaid Money Follows the Person Demonstration grants extended making it easier for some to move back into their communities New Federal Coordinated Health Care Office to improve care coordination for people in both Medicare and Medicaid Effective date Effective 2014 Effective Formally established by CMS Dec. 30, 2010

10 What Is Not Changing? 1. Employers and individual policyholders can keep same plans 2. Individuals can still get COBRA benefits 3. HIPAA/Medical Privacy 4. Family Medical Leave Act (FMLA)

11 Other Notable Changes in the ACA Other Important Provisions Provision FDA is authorized to approve biosimilar versions of biologic drugs New standards for accessibility for medical diagnostic equipment including exam tables, chairs, scales, X-ray and other imaging technology Health insurers must use standardized information and terminology in all documents to make coverage easier to understand and use. Effective date Effective upon enactment Effective March 2012 Effective September 2012

12 Health Insurance Exchanges: A New Way to Shop for Coverage States choices for establishing new online marketplaces: Create their own Exchange (16 and District of Columbia) Use the federal Marketplace (34) Purpose of Exchange/Marketplace To compare / purchase private health insurance Qualified Health Plans (QHPs) Premium Tax Credits only available with FFM plans Also available to small employers Fewer than 50 full time equivalent employees Small Business Health Options Program SHOP

13 Open Enrollment October 1,2013 March 31,2014 Coverage can begin January 1, 2014 IF ENROLLED BY Special Enrollment after March to enroll in or change QHPs (45 CFR ). For example: Loss of other coverage (except for non-payment, rescission) Birth, adoption, marriage Change in immigration status Error by FFM Other exceptional circumstances Note: Medicaid applications accepted & processed all year

14 Basic Eligibility for Marketplace Insurance with Premium Tax Credits Income between 100%-400% federal poverty line Family Size 100% FPL 400% FPL 1 $11,490 $45,960 2 $15,510 $62,040 3 $19,530 $78,120 4 $23,550 $94,200 No affordable job-based coverage Not affordable if employee-only plan: costs 9.5% family income; or covers 60% costs

15 Insurance Marketplace How to Apply Multiple doors for applications Online Phone Local Departments of Social Services By mail: Federal Paper Application - Other-Resources/Downloads/marketplace-app-standard.pdf

16 Information Needed to Apply Availability of Employer-based Coverage Identity of applicants Name and contact info Social Security Number Immigration Status Household Size Using tax code principles & expected HH in 2014 Countable Income Using tax code principles & expected income in 2014 Data bases will verify a lot of information Paper documents last resort

17 Standardized coverage = 10 essential health benefits (EHB) All qualified health plans must cover: 1.Ambulatory patient services 2.Emergency services 3.Hospitalization 4.Maternity & newborn care 5.Mental health & substance use disorder services, including behavioral health treatment 6.Prescription drugs 7.Rehabilitative & habilitative services & devices 8.Laboratory services 9.Preventive & wellness services & chronic disease management, & 10.Pediatric services, including oral & vision care

18 Help for People with High Medical Costs Annual maximum out-of-pocket costs for all In-Network, Essential Health Benefits More cost-sharing help for low income households: SILVER PLAN ONLY If under 200% of Federal Poverty Level, max out-of-pocket $2250 Individual/$4500 Family If % of Federal Poverty Level, $5200 Individual or $10,400 Family Expanded appeal rights including external review Lifetime caps abolished, annual caps limited

19 Conclusion Overall, many structural changes in health care system Some changes were immediate, others on schedule to 2020 The National MS Society will continue to analyze how new provisions will impact people and families living with MS Look for notifications on our webpage,, on , and through our periodicals like Momentum. For general questions about health care reform: The official site of the federal government, provides comprehensive information about the new law, with details on health insurance options for individuals in every state. (In English and Spanish) If you have specific questions about how ACA will impact your MS treatment, contact the National MS Society Call us! Online:

THE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER

THE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER THE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER Overview Affordable Care Act, aka Obamacare Goals Affordable Insurance Coverage

More information

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 HEALTHCARE.GOV Affordable Care Act Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 Joanne Corte Grossi, MIPP Regional Director U.S. Department of Health

More information

Maryland s New Health Insurance Marketplace. What You Need To Know About Getting Health Coverage

Maryland s New Health Insurance Marketplace. What You Need To Know About Getting Health Coverage Maryland s New Health Insurance Marketplace What You Need To Know About Getting Health Coverage Goals Today The Importance of Coverage What is Maryland Health Connection? New coverage options Qualified

More information

The Vermont Health Benefit Exchange: An Update

The Vermont Health Benefit Exchange: An Update The Vermont Health Benefit Exchange: An Update Today s Discussion Health Reform Goals & Timeline Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like? Plan Design Enrollment

More information

The Vermont Health Benefit Exchange: An Update for Small Business Owners

The Vermont Health Benefit Exchange: An Update for Small Business Owners The Vermont Health Benefit Exchange: An Update for Small Business Owners Today s Presentation Health Reform Goals Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like?

More information

The Affordable Care Act. President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010.

The Affordable Care Act. President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010. The Affordable Care Act President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010. The ACA was enacted to: v Increase quality and affordability of health insurance v Lower the uninsured

More information

Health Insurance Marketplace 101 1

Health Insurance Marketplace 101 1 Affordable Care Act Coverage Accomplishments May 2013 3.1 million young adults have gained insurance through their parents plans 6.1 million people with Medicare through 2012 received $5.7 billion in prescription

More information

Section 2: INDIVIDUALS WHO CURRENTLY HAVE

Section 2: INDIVIDUALS WHO CURRENTLY HAVE Section 2: INDIVIDUALS WHO CURRENTLY HAVE COVERAGE OR AN OFFER OF COVERAGE FROM THEIR EMPLOYER Section 2 covers enrollment issues for individuals who have coverage or an offer of coverage whether through

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2014 AFFORDABLE CARE ACT» The Affordable Care Act: Establishes a Health

More information

This glossary provides simple and straightforward definitions of key terms that are part of the health reform law.

This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. A Affordable Care Act Also known as the ACA. A law that creates new options for people

More information

The Health Insurance Marketplace 101

The Health Insurance Marketplace 101 The Health Insurance Marketplace 101 Introduction to the Marketplace The Health Insurance Marketplace (or Exchange) Place for individuals and small employers to directly compare private health insurance

More information

The Affordable Care Act and People with Disabilities

The Affordable Care Act and People with Disabilities The Affordable Care Act and People with Disabilities The Arc of Texas envisions a world where people with disabilities are included in their communities and neighborhoods and where quality supports and

More information

Maryland Health Connection

Maryland Health Connection Maryland Health Connection What You Need To Know About Getting Health Coverage MarylandHealthConnection.gov Goals Today The importance of coverage What is Maryland Health Connection? Coverage options Qualified

More information

Health Care Reform Update

Health Care Reform Update Small Businesses No Financial Requirements for Small Businesses: The ACA imposes no financial requirements for small businesses to contribute to their employees health insurance. However, beginning in

More information

The Health Insurance Marketplace 101. July 2013

The Health Insurance Marketplace 101. July 2013 The July 2013 The Problem Insurance companies could turn away the 129 million Americans with pre-existing conditions Premiums had more than doubled over the last decade, while insurance company profits

More information

Health Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014

Health Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014 vhealth insurance exchanges Health Insurance Marketplace What to expect in 2014 What to expect in 2014 The basics of exchanges As part of the Affordable Care Act (ACA or health care reform law), starting

More information

The Health Insurance Marketplace 101. May 2013

The Health Insurance Marketplace 101. May 2013 The Health Insurance Marketplace 101 May 2013 Affordable Care Act Coverage Accomplishments 3.1 million young adults have gained insurance through their parents plans 6.1 million people with Medicare through

More information

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS The Affordable Care Act: A Working Guide for MCH Professionals Module 2 GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS Overview A fundamental first step in accessing health care in the United States is having

More information

Fact Sheet. AARP Public Policy Institute. Health Reform Changes Insurance Rules

Fact Sheet. AARP Public Policy Institute. Health Reform Changes Insurance Rules Fact Sheet Health Reform Changes Insurance Rules The Affordable Care Act (ACA) will greatly increase the availability of health insurance and broadly impact the delivery of health care in America. This

More information

Federal Health Reform FAQs

Federal Health Reform FAQs Federal Health Reform FAQs Individuals 1. What is an exchange? An exchange, as created under the Affordable Care Act (ACA), is a place where consumers can purchase subsidized health insurance coverage.

More information

Presented by South Dakota Community Action Partnership

Presented by South Dakota Community Action Partnership Presented by South Dakota Community Action Partnership The project described was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S Department of Health and Human Services, Centers for

More information

David Lyons Founding Director and Chief Executive Officer

David Lyons Founding Director and Chief Executive Officer The New Health Insurance Marketplace Changes Impacting Small Employers and the SHOP Opportunity David Lyons Founding Director and Chief Executive Officer CoOportunity Health 10/1/2013 1 Why the Change?

More information

Find health care options that meet your needs and fit your budget.

Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. January 2015 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law

More information

Exchanges and the ACA What You Need to Know for 2014

Exchanges and the ACA What You Need to Know for 2014 Exchanges and the ACA What You Need to Know for 2014 How the Affordable Care Act affects the Individual Health Insurance Market This presentation is for informational purposes only and does not constitute

More information

Health Insurance Marketplace 101

Health Insurance Marketplace 101 Health Insurance Marketplace 101 The Marketplace is open! Find health care options that meet your needs and fit your budget. The Health Care Law In March 2010, President Obama signed the Affordable Care

More information

Health Insurance Marketplaces

Health Insurance Marketplaces Health Insurance Marketplaces 2013 Zywave, Inc. All rights reserved. Presented by Employer Flexible What is Health Care Reform? The Affordable Care Act (ACA) was enacted in March 2010. Biggest overhaul

More information

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers This page provides answers to frequently asked questions (FAQ) regarding The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010

More information

The Healthcare Law April 19, 2010

The Healthcare Law April 19, 2010 The Healthcare Law April 19, 2010 This healthcare bill, recently made law, is a comprehensive overhaul that increases coverage to 94% of Americans and makes sweeping changes to our current healthcare system.

More information

THE KANSAS AFFORDABLE CARE ACT IMPLEMENTATION. Linda J. Sheppard November 6, 2014

THE KANSAS AFFORDABLE CARE ACT IMPLEMENTATION. Linda J. Sheppard November 6, 2014 THE KANSAS AFFORDABLE CARE ACT IMPLEMENTATION Linda J. Sheppard November 6, 2014 The Kansas Market Approximately 348,000 Kansans are uninsured - 12.3% of the state s population 44,130 are children, but

More information

AFFORDABLE CARE ACT FAQ

AFFORDABLE CARE ACT FAQ AFFORDABLE CARE ACT FAQ What is the Healthcare Insurance Marketplace? The Marketplace is a new way to find quality health coverage. It can help if you don t have coverage now or if you have it but want

More information

5Want to know more about the health

5Want to know more about the health www. WHAT S INSIDE STEPS TO UNDERSTANDING OBAMACARE Introduction 4 Step 1 Does your current health insurance plan need to change? 6 Step 2 How will you pay for health insurance in 2014? 10 Step 3 What

More information

Senate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)**

Senate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)** Prevention and Screening Services Cost-sharing Eliminates cost sharing requirements for requirements for all preventive services (including prevention and colorectal cancer screening) that have a screening

More information

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget.

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. March 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law

More information

The Affordable Care Act: Overview & Impact on Adult Immunizations

The Affordable Care Act: Overview & Impact on Adult Immunizations The Affordable Care Act: Overview & Impact on Adult Immunizations Adult Immunization Leadership Summit February 1, 2013 Barbara Flye, Senior Health Policy Advisor Office of the Insurance Commissioner 1

More information

HEALTH CARE REFORM CHECKLIST

HEALTH CARE REFORM CHECKLIST HEALTH CARE REFORM CHECKLIST As a small employer, you need to be aware of the new regulations tied to the Affordable Care Act. Refer to this checklist to ensure you understand each one and that you re

More information

THE HEALTH INSURANCE MARKETPLACE

THE HEALTH INSURANCE MARKETPLACE THE HEALTH INSURANCE MARKETPLACE Presented by Raffa Financial Services Source: Centers for Medicare & Medicaid Services Design 2013 Zywave, Inc. All rights reserved. OBJECTIVES This session will help you:

More information

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace Understanding the ObamaCare Health Insurance Plans in North Carolina As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with

More information

HEALTH INSURANCE MARKETPLACES FACT SHEET

HEALTH INSURANCE MARKETPLACES FACT SHEET HEALTH INSURANCE MARKETPLACES FACT SHEET INFORMED ON REFORM Overview A Health Insurance Marketplace, also known as a Health Insurance Exchange, is available in every state as a public option for individuals

More information

Understanding the Affordable Care Act

Understanding the Affordable Care Act Understanding the Affordable Care Act The Affordable Care Act (officially called the Patient Protection and Affordable Care Act) is the law that mandates that everyone in the United States maintain health

More information

AMERICAN HEALTH BENEFIT EXCHANGES

AMERICAN HEALTH BENEFIT EXCHANGES AMERICAN HEALTH BENEFIT EXCHANGES As we have previously reported, beginning January 1, 2014, the GHLIT will stop offering AVMA members medical insurance. However, members and small employers will be able

More information

The Affordable Care Act: Health Coverage Options & Considerations in 2014

The Affordable Care Act: Health Coverage Options & Considerations in 2014 The Affordable Care Act: Health Coverage Options & Considerations in 2014 J A C K S O N V I L L E A R E A C H A M B E R O F C O M M E R C E A U G U S T 2 7, 2 0 1 3 L A U R A M I N Z E R E X E C U T I

More information

Health insurance Marketplace. What to expect in 2014

Health insurance Marketplace. What to expect in 2014 Health insurance Marketplace What to expect in 2014 Overview The Affordable Care Act (ACA) includes several provisions geared to extend greater access to health insurance benefits to more people. Beginning

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

TO UNDERSTANDING THE AFFORDABLE CARE ACT

TO UNDERSTANDING THE AFFORDABLE CARE ACT 3 STEPS TO UNDERSTANDING THE AFFORDABLE CARE ACT What s Inside Step 1: What Understand what you re buying 4 Step 2: How How can you buy health insurance? 20 STEPS TO UNDERSTANDING THE AFFORDABLE CARE ACT

More information

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform.

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform. WHAT IS HEALTHCARE REFORM? Healthcare Reform (HCR) is a law passed by Congress that provides many different requirements. A very important aspect of the law is that it is designed to provide individuals

More information

Issue Brief: The Health Benefit Exchange and the Small Employer Market

Issue Brief: The Health Benefit Exchange and the Small Employer Market Issue Brief: The Health Benefit Exchange and the Small Employer Market Overview The federal health care reform law directs states to set up health insurance marketplaces, called Health Benefit Exchanges,

More information

How Health Reform Will Help Children with Mental Health Needs

How Health Reform Will Help Children with Mental Health Needs How Health Reform Will Help Children with Mental Health Needs The new health care reform law, called the Affordable Care Act (or ACA), will give children who have mental health needs better access to the

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion

Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion Table of Contents Expanded Coverage... 2 Health Insurance Exchanges... 3 Medicaid Expansion... 8 Novartis Pharmaceuticals Corporation

More information

Affordable Care Act Policy and Implementation Briefing

Affordable Care Act Policy and Implementation Briefing HEALTHCARE.GOV Affordable Care Act Policy and Implementation Briefing Family Planning Council s Reproductive Health Conference April 27, 2012 Joanne Corte Grossi,, MIPP Regional Director U.S. Department

More information

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions.

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions. Informational Series Glossary of Health Insurance & Medical Terminology How to use this glossary This glossary has many commonly used terms, but isn t a full list. These glossary terms and definitions

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2015 AFFORDABLE CARE ACT OVERVIEW» The Affordable Care Act was enacted

More information

Preventive Services. Essential Health Benefits. Exceptions. The Affordable Care Act: A Working Guide for MCH Professionals. Section 6 BENEFITS

Preventive Services. Essential Health Benefits. Exceptions. The Affordable Care Act: A Working Guide for MCH Professionals. Section 6 BENEFITS The Affordable Care Act: A Working Guide for MCH Professionals Section 6 BENEFITS In addition to expanding access to affordable health coverage options, the Affordable Care Act (ACA) makes several changes

More information

Understanding the Health Insurance Marketplace. August 2013

Understanding the Health Insurance Marketplace. August 2013 Understanding the Health Insurance Marketplace August 2013 Objectives This session will help you Explain the Health Insurance Marketplace Identify who will benefit Define who is eligible Explain the enrollment

More information

www.thinkhr.com 877-225-1101 Employer Health Reform Checklist

www.thinkhr.com 877-225-1101 Employer Health Reform Checklist www.thinkhr.com 877-225-1101 Employer Health ThinkHR grants the reader non-exclusive, non-transferable, and limited permission to use this document. The reader may not sell or otherwise use this document

More information

Find health care options that meet your needs and fit your budget. ctober 2014

Find health care options that meet your needs and fit your budget. ctober 2014 O Health Insurance Find health care options that meet your needs and fit your budget. ctober 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law generally requiring

More information

Health Care Reform Overview How Will People with Hepatitis Benefit?

Health Care Reform Overview How Will People with Hepatitis Benefit? Health Care Reform Overview How Will People with Hepatitis Benefit? A N N E D O N N E L L Y, H E A L T H C A R E P O L I C Y, P R O J E C T I N F O R M R A C H E L M C L E A N, A D U L T V I R A L H E

More information

One of the more visible changes soon to be brought MONTANA S HEALTH INSURANCE A PREVIEW OF MARKETPLACE

One of the more visible changes soon to be brought MONTANA S HEALTH INSURANCE A PREVIEW OF MARKETPLACE A PREVIEW OF MONTANA S HEALTH INSURANCE MARKETPLACE by Gregg Davis and Christina Goe One of the more visible changes soon to be brought to the forefront by passage of the Affordable Care Act (ACA) is the

More information

The Affordable Care Act: Its Impact on People with Serious Chronic Diseases

The Affordable Care Act: Its Impact on People with Serious Chronic Diseases The Affordable Care Act: Its Impact on People with Serious Chronic Diseases PSC Partners Annual Conference Victoria Veltri, JD, LLM State Healthcare Advocate April 26, 2013 Discussion Areas What is the

More information

The Health Benefit Exchange and the Commercial Insurance Market

The Health Benefit Exchange and the Commercial Insurance Market The Health Benefit Exchange and the Commercial Insurance Market Overview The federal health care reform law directs states to set up health insurance marketplaces, called Health Benefit Exchanges, that

More information

Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange

Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange The Affordable Care Act (ACA) makes health insurance available to nearly all Americans and the law requires

More information

Affordable Care Act 101: Understanding Federal Healthcare Reform

Affordable Care Act 101: Understanding Federal Healthcare Reform Affordable Care Act 101: Understanding Federal Healthcare Reform As of July 16, 2013 For more Information, please contact the Office of Countywide Healthcare Planning by e-mail: healthcareplanning@miamidade.gov

More information

OVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS

OVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS OVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS Brief Prepared by MATTHEW COKE Senior Research Attorney LEGISLATIVE

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

Affordable Care Act Toolkit

Affordable Care Act Toolkit Affordable Care Act Toolkit for Individuals and Families Choose coverage that fits. Form No. 3-1017 (07-14) Individuals and Families Healthcare Reform What does it mean for you? The following outline

More information

A Consumer s Guide to the Affordable Care Act

A Consumer s Guide to the Affordable Care Act A Consumer s Guide to the Affordable Care Act The Affordable Care Act was designed to help make health care affordable for everyone. This guide will help you understand how the ACA affects individuals

More information

Tobacco Cessation and the Affordable Care Act. Jennifer Singleterry Director, National Health Policy American Lung Association

Tobacco Cessation and the Affordable Care Act. Jennifer Singleterry Director, National Health Policy American Lung Association Tobacco Cessation and the Affordable Care Act Jennifer Singleterry Director, National Health Policy American Lung Association Background on ACA Acronyms ACA = Affordable Care Act (healthcare reform) HHS

More information

Access to Health Insurance Regulation Update

Access to Health Insurance Regulation Update Health Care Compliance Association 2014 Puerto Rico Regional Annual Conference Access to Health Insurance Regulation Update Ángela Weyne Roig Commissioner of Insurance Office of the Commissioner of Insurance

More information

HEALTH REFORM and VACCINES: Review of Federal Legislation

HEALTH REFORM and VACCINES: Review of Federal Legislation HEALTH REFORM and VACCINES: Review of Federal Legislation The Patient Protection and Affordable Care Act (PPACA) And The Health Care and Education Reconciliation Act Alexandra Stewart June 2, 2012 1 Presentation

More information

www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST

www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable

More information

Kansas Insurance Department

Kansas Insurance Department Kansas Insurance Department The Affordable Care Act What Happens Now? Kansas Society of CPAs June 5, 2013 Linda J. Sheppard, Special Counsel & Director of Health Care Policy and Analysis 2010 Affordable

More information

SHIBA. Statewide Health Insurance Benefits Advisors. Medicare, Health Insurance, & the Affordable Care Act Updates for Summer 2013

SHIBA. Statewide Health Insurance Benefits Advisors. Medicare, Health Insurance, & the Affordable Care Act Updates for Summer 2013 SHIBA Statewide Health Insurance Benefits Advisors Medicare, Health Insurance, & the Affordable Care Act Updates for Summer 2013 Liz Mercer Regional Trainer Sponsored by the: 8/8/2013 1 Today s overview

More information

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST HR COMPLIANCE CENTER

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST HR COMPLIANCE CENTER AFFORDABLE CARE ACT Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Provisions take effect on staggered dates

More information

Healthcare Reform Preparedness for Small Businesses

Healthcare Reform Preparedness for Small Businesses Healthcare Reform Preparedness for Small Businesses Blue KC on Wheels Community awareness initiative Health screenings Wellness information Seminars on healthcare reform, health insurance and wellness

More information

Healthcare Reform for Tennesseans A NEW ERA IN HEALTH CARE FOR TENNESSEANS

Healthcare Reform for Tennesseans A NEW ERA IN HEALTH CARE FOR TENNESSEANS Healthcare Reform for Tennesseans A NEW ERA IN HEALTH CARE FOR TENNESSEANS Agenda What s a CO-OP? Who benefits from it? Get to know CHA Timeline Who s Affected Marketplace New Requirements Questions 2

More information

Health Insurance Quick Reference Guide

Health Insurance Quick Reference Guide Health Insurance Quick Reference Guide This Quick Reference Guide is designed to assist you to understand health insurance information. Table of Contents 1. General Health Insurance Information... 3 2.

More information

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers?

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers? The Patient Protection and Affordable Care Act (ACA) includes provisions that will have significant implications for individuals, families and employers in 2014. These provisions include: The creation

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

The Affordable Care Act: What Does it Mean for Individuals and Families?

The Affordable Care Act: What Does it Mean for Individuals and Families? The Affordable Care Act: What Does it Mean for Individuals and Families? FIRM Team Fact Sheet 13-04 Available at http://www.firm.msue.msu.edu David B. Schweikhardt Adam J. Kantrovich Brenda R. Long Michigan

More information

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST AFFORDABLE CARE ACT SMALL EMPLOYER Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform

More information

The Affordable Care Act in New Hampshire

The Affordable Care Act in New Hampshire The State of New Hampshire Insurance Department 21 South Fruit Street, Suite 14 Concord, NH 03301 (603) 271-2261 Fax (603) 271-1406 TDD Access: Relay NH 1-800-735-2964 The Affordable Care Act in New Hampshire

More information

Hospitals and the Affordable Care Act (ACA)

Hospitals and the Affordable Care Act (ACA) Hospitals and the Affordable Care Act (ACA) General Housekeeping If you experience any technical difficulties during the webinar, please contact GoToMeeting.com Corporate Account Customer Support at: 1-888-259-8414

More information

Affordable Care Act (ACA) Frequently Asked Questions

Affordable Care Act (ACA) Frequently Asked Questions Grandfathered policies Q1: What is grandfathered health plan coverage? A: The interim final rule on grandfathering under ACA generally defines grandfathered health plan coverage as coverage provided by

More information

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE Laurus Strategies Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE The Affordable Care Act (ACA) requires non grandfathered health insurance plans in the individual and

More information

HHealth HEALTH INSURANCE EXCHANGE FAQs

HHealth HEALTH INSURANCE EXCHANGE FAQs HHealth HEALTH INSURANCE EXCHANGE FAQs Page 1 TABLE OF CONTENTS Introduction... 3 Background... 3 Health Insurance Exchange FAQs... 4 What is the Patient Protection and Affordable Care Act (PPACA)?...

More information

Affordable Care Act and Adolescents and Young Adults

Affordable Care Act and Adolescents and Young Adults Affordable Care Act and Adolescents and Young Adults Overview of Summit Welcome and Introductions Affordable Care Act 101 Affordable Care Act and Impact on Adolescents and Young Adults Federal Update on

More information

THE AFFORDABLE CARE ACT: THE AFFORDABLE COVERAGE OPTIONS AND CONSIDERATIONS IN 2014 THE NEW HEALTH INSURANCE: MARKETPLACE AND MEDICAID

THE AFFORDABLE CARE ACT: THE AFFORDABLE COVERAGE OPTIONS AND CONSIDERATIONS IN 2014 THE NEW HEALTH INSURANCE: MARKETPLACE AND MEDICAID THE AFFORDABLE CARE ACT: THE AFFORDABLE COVERAGE OPTIONS AND CONSIDERATIONS IN 2014 THE NEW HEALTH INSURANCE: MARKETPLACE AND MEDICAID Deloris Summers Deaf In-Person Counselor Navigator Jacksonville Area

More information

How the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1

How the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1 How the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1 General 1. Did Oklahoma expand Medicaid? No, Oklahoma did not expand Medicaid. 2. Who is

More information

Why the Affordable Care Act Matters for Women: Health Insurance 101

Why the Affordable Care Act Matters for Women: Health Insurance 101 Why the Affordable Care Act Matters for Women: Health Insurance 101 APRIL 2014 Women are the health care decision makers in our country they make approximately 80 percent of the health care decisions in

More information

Affordable Care Act Toolkit

Affordable Care Act Toolkit Affordable Care Act Toolkit for Businesses with less than 50 employees Choose coverage that fits. Form No. 3-1018 (07-14) Small Groups The Affordable Care Act Blue Cross of Idaho prepared this toolkit

More information

Kansas Insurance Department

Kansas Insurance Department Kansas Insurance Department A Kansas Guide to Health Insurance Changes Public Policy Session Panel Discussion KAMU Annual Conference Sept. 26, 2013 Sandy Praeger, Commissioner of Insurance 2014 Affordable

More information

Timeline of New Health Care Law and Its Impact on American Businesses

Timeline of New Health Care Law and Its Impact on American Businesses Timeline of New Health Care Law and Its Impact on American Businesses Summaries of the Patient Protection and Affordable Health Care Act (Public Law 111-148) Health Care and Education Reconciliation Act

More information

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: November 2014

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: November 2014 AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless

More information

Successes and Challenges in the Affordable Care Act: Beyond Access

Successes and Challenges in the Affordable Care Act: Beyond Access Successes and Challenges in the Affordable Care Act: Beyond Access Robert Greenwald Clinical Professor of Law, Harvard Law School Director, Center for Health Law and Policy Innovation/Treatment Access

More information

The Effect of the Affordable Care Act on Your Small Business. Presented to : Greater Kansas City Chamber Business Class

The Effect of the Affordable Care Act on Your Small Business. Presented to : Greater Kansas City Chamber Business Class The Effect of the Affordable Care Act on Your Small Business Presented to : Greater Kansas City Chamber Business Class November 6, 2013 KHN Kaiser Health News Current Headlines October 31- November 4,

More information

APRIL 2015 SECTION I - 1. Section I: Introduction and Overview

APRIL 2015 SECTION I - 1. Section I: Introduction and Overview Section I: Introduction and Overview About Us... I-2 Resources... I-3 Sharp Health Plan s Responsibilities... I-4 Service Area... I-4 Compliance Program... I-4 Health Care Fraud, Waste, and Abuse Prevention...

More information

Presentation for Licensed Producers The Affordable Care Act

Presentation for Licensed Producers The Affordable Care Act Presentation for Licensed Producers The Affordable Care Act Bruce Donaldson, CHC Producer & Stakeholder Specialist Arkansas Insurance Department Affordable Care Act The ACA was passed by Congress and signed

More information

The Health Insurance Marketplace 101

The Health Insurance Marketplace 101 The Health Insurance Marketplace 101 National Newspaper Association 127th Annual Convention & Trade Show September 13, 2013 Office of the Regional Director Community Resource California-Based Arizona,

More information

Health Insurance Marketplace Frequently Asked Questions

Health Insurance Marketplace Frequently Asked Questions Health Insurance Marketplace Frequently Asked Questions Q & A SPECIFIC TO THE HEALTH INSURANCE MARKETPLACE & ASSISTANCE Q1: Why is health insurance important? A: No one plans to get sick or hurt, but at

More information

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: October 2015

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: October 2015 AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless

More information