Texas Voice for Health Reform Update | July 1, 2010
In this issue…
Implementation Road Show
Update on Health Reform Implementation
- Applications for the Pre-existing Condition Insurance Program (PCIP) start today!
- Federal Government Launches www.healthcare.gov
- Early Retiree Reinsurance Program
- Patient’s Bill of Rights
- Prevention and Public Health Fund
- Analysis of the PPACA by the National Health Law Program
- New Health Reform Implementation Guides
IMPLEMENTATION ROAD SHOW
Texas Voice for Health Reform is hitting the road to educate Texans about health reform implementation. As we confirm events we will update our online calendar with all the details. Look for the events in blue! If you don’t see an event in your area and would like to host one, please contact Dunkelberg@cppp.org!
UPDATE ON HEALTH REFORM IMPLEMENTATION
Starting on Thursday, July 1, applications for the Pre-existing Condition Insurance Program (PCIP), the new federally-mandated state high risk pools, will be available online at www.pcip.gov. The new high risk pool will operate separately from Texas’ current high risk pool and will be available to Texans who have been denied coverage because of a pre-existing condition and who have been uninsured for at least six months. Those who enroll in July could receive coverage as early as August. Premiums for the new program will not be available until July 15, but the estimated premium for a 50-year old will be between $491 and $600 per month.
A new consumer-focused website with health coverage options, www.healthcare.gov, also launches on July 1. It will help consumers locate both private and public coverage options that may be available to them based on where they live. The site guides consumers through a few simple questions (Are you disabled, a young adult, a senior? Are you pregnant? Are you losing job-based coverage?) to produce a list of possible coverage options based on the consumer’s situation. The site also has clear information on the new health reform law.
Included in the PPACA is the Early Retiree Reinsurance Program that could provide federal funds to state and local governments to assist with the costs of health coverage to early retirees. The provision establishes a reinsurance program, which will be in effect from June 1, 2010 until 2014 when the major coverage provisions in health reform take effect. The program provides reimbursement to employers including state and local governments of up to 80 percent of claims for health benefits between $15,000 and $90,000 incurred by retirees who are 55 and older and who are not eligible for Medicare. Claims on behalf of spouses, surviving spouses and dependents are also covered. Reimbursements received under the reinsurance program must be used to lower the costs of the health plan either by reducing the employer’s costs or to reduce premium contributions, deductibles, co—payments or other charges for plan participants. Employers must submit applications to participate in the program, and $5 billion has been appropriated for the program. See this fact sheet to learn more. The U.S. Department of Health and Human Services started accepting applications for the program as of June 29, 2010.
Three federal agencies released a package of rules last week that they have identified as the Patient’s Bill of Rights. Included in this rule package are provisions that prohibit health plans from applying pre-existing conditions exclusions to children in plan years that begin after September 23, 2010. Visit this Fact Sheet to learn how the new rules will affect you.
In June, the U.S. Department of Health and Human Services announced the investment of $500 million this year made available through the new Prevention and Public Health Fund in health reform to prevent disease, detect it early, better manage conditions, and improve health.
Half of the funding has been allocated to increase the number of primary care providers by creating additional primary care residency slots; training new physician assistants and nurse practitioners; establishing new nurse-practitioner led clinics; and helping states plan for and implement strategies to meet primary care workforces needs.
The other half of the funding has been allocated to support prevention activities and develop public health infrastructure, including the integration of primary care services into publicly funded community-based behavioral health settings; obesity prevention and fitness; tobacco cessation; data collection; and public health workforces training.
Analysis of the PPACA and Reconciliation health care reform laws by the National Health Law Program (3 parts)
- Part 1 includes an analysis of the private insurance reforms and state-based exchanges
- Part 2 includes an analysis of changes to the Medicaid program; and
- Part 3 analyzes selected provisions from other titles of the PPACA and Reconciliation law.
New Implementation Guides!
Implementing Health Reform: Key Questions for States, by the Georgetown Center for Children and Families
Delivering on the Promise, by TexPIRG “shows how state policy makers can implement and improve on the law to ensure it offers the best deal to consumers.”
Navigating Health Care Reform-An Employers Guide, by United Healthcare “… are designed to assist [employers] by highlighting some of the changes made by the legislation, and setting out general timelines.”