Texas Voice for Health Reform Update | August 4, 2010
In this Issue…
Implementation Road Show
- New Events!
Update on Health Reform Implementation
- Consumer Assistance Grants
- New Pre-Existing Condition Plan
- Update on Health Insurance Exchanges
- Consumer Appeal Rights
- Support for Health Reform Growing
- From the Kaiser Family Foundation
- State Legislator’s Checklist for Health Reform Implementation
- Small Employer Tax Credits
- Families USA’s “Virtual Patient”
- New Resources on Health Insurance Exchanges
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
Grants available to states for health insurance consumer assistance
Federal HHS announced $29 million in grants available to states to establish a health insurance consumer assistance or ombudsman program through: the insurance department, attorney general, independent consumer assistance agency, or a contract or partnership with one or more non-profit organizations. To qualify, states must explain how the program will demonstrate independence, assist people with all types of coverage, collect data about any problems and questions, and provide assistance in a culturally appropriate manner. Each state is eligible for only one grant award based on population (Texas’ award should be around $2.3 million). Applications are due from states on September 10, 2010. For more information:
New Pre-existing Conditions Insurance Plan available
Texans who have been uninsured for at least 6 months and have a pre-existing condition can now enroll in the new Pre-existing Condition Insurance Plan established by the health reform law. Rates for the new plan are based on an enrollee’s age:
- Ages 0 to 34: $323
- Ages 35 to 44: $387
- Ages 45 to 54: $495
- Ages 55+: $688
Full information on the plan benefits, provider networks, and links to applications (starting on 8/1, people can also apply online) is at www.pciplan.com.
Texas also has an existing, state-administered high risk pool – the Texas Health Insurance Pool. CPPP released a report in July that explains both programs—how they are similar and different—to help people who can’t get regular coverage because of pre-existing conditions better understand their options.
Two New Announcements on Health Insurance Exchanges
Federal HHS announced $51 million in grants to states (up to $1 million for each state) to help states start the research and planning necessary to create a health insurance Exchange. The new health reform law creates Exchanges, which will allow individuals and small businesses to do “one-stop-shopping” to compare and purchase health insurance coverage. States have the option to establish and operate their own Exchange or partner with other states to create a regional Exchange. Should a state choose not to operate an Exchange, HHS will run one for that state. Exchanges must be operational by January 1, 2014. Applications are due on September 1. Additional rounds of grants will be available to states in the future as states continue planning and start creating their Exchanges.
HHS also announced a request for comments from states, consumer advocates, employers, insurers, and other interested stakeholders, asking for input as HHS develops rules and standards for Exchanges.
Consumer appeal rights strengthened
Federal HHS has proposed rules to implement stronger consumer appeal rights passed in health reform. Details on appeal rights are available in this fact sheet. The new rules guarantee that health plan enrollees can appeal rescission of coverage and claims denials directly to insurers and then to an independent, external review board, if necessary. The rules set standards for appeals processes that will help deliver a full and fair review for consumers.
Tracking polls show support for health reform growing
The Kaiser Family Foundations monthly tracking poll for July showed the highest approval level for health reform since it was passed into law in March. Fifty percent of the public reported a favorable view of the law, with 35 percent opposed (down from 41 percent the previous month). Fourteen percent reported no opinion.
This report examines lessons learned from past state experience with expanding coverage to childless adults. Many best practices for enrolling parents and children in Medicaid will apply to childless adults, but successful efforts will also require new strategies and messages given their historic ineligibility for Medicaid, limited connection to public programs, fluctuating incomes and language and cultural barriers. Given the significance and size of the expansion, it will be imperative for states to be ready and prepared with the necessary systems, technology, and administrative capacity in place to process enrollments and coordinate coverage and care with the new Health Insurance Exchanges.
National Conference of State Legislatures, State Legislators’ Check List for Health Reform Implementation FY 2010
Families USA, A Helping Hand for Small Businesses, Small Employer Tax Credits
The report finds that 81% of Texas small businesses (those with 25 of fewer employees), or over 248,000 Texas businesses will qualify for new small business tax credits this year to help them purchase health insurance.
Families USA, Learn more about what improved access to preventive services will mean for you. Thanks to the new health care law, Americans will get timely preventive services that will allow them to stay healthy both now and in the future. Families USA’s new ‘virtual patient’ will help you learn what this means for you.
And several new resources about Exchanges….
Robert Wood Johnson Foundation, “Health Benefit Exchanges: An Implementation Timeline for State Policymakers”
The timeline sets out the tasks that are needed to get an exchange up and running so that coverage begins in January 2014.
The Commonwealth Fund, Health Insurance Exchanges and the Affordable Care Act: Key Policy Issues
This report identifies issues that came up in earlier attempts to create Exchanges, key policies to overcome those problems, and ACA’s provisions related to Exchanges.
Consumer advocates provide testimony on health insurance Exchanges
The National Association of Insurance Commissioner held an interim meeting in Washington, DC July 22-23 to hear from stakeholders on health insurance Exchanges. Consumer advocates provided testimony on important Exchange functions and consumer protections as well as enrollment procedures and coordination with Medicaid and CHIP