CBHC Statewide Conference Call: Monday, March 12

Please register to join us for the Campaign for Better Health Care's next Statewide Conference Call: "We See What You Are Doing, and We Are Not Pleased: The Right's Attack on Women's Health" on Monday, March 12, 12 pm CST

The right has launched a series of blistering attacks on women's health care: within the past two weeks alone, we've seen their efforts to reduce access to contraception, to mandate unnecessary transvaginal ultrasound procedures for women seeking abortions, to slash funding for reproductive health clinics, and to demonize and defund organizations that provide women's reproductive health services, like Planned Parenthood. These ideological attacks are not just mere politics as usual from the right; they are a means to their true end game, destroying the Affordable Care Act.

On March 26, the Supreme Court will begin hearings on the constitutionality of the personal responsibility clause of the Affordable Care Act. Personal responsibility for the common good means that because everyone has insurance, no one gets to rig the system, everyone has equal skin in the game, and no one rides for free, including the insurance industry. It means that people can't enter the insurance pool only when they become sick, thereby draining the pool of dollars they haven't paid in previously. Making sure everyone pays equally so they can benefit equally is the only way we can keep a system of social insurance going. The opposition's argument against the personal responsibility clause of the Affordable Care Act is their argument against social insurance: how dare anyone force them to pay their fair share and take away their ability to rip the system off and raise costs for everyone else?

The attack on women's rights is not just about addressing health disparities for women, but gives us the opportunity in Illinois to fix racial disparities, income disparities, and other disparities in our current health care system. In building a competitive health care marketplace (insurance exchange) that addresses the disparities, we begin to take the necessary steps to correct them across the board. Women did not want this fight, but it was brought and we will win it by using this opportunity to build a health care system that provides quality, affordable health care for ALL.

Please join us on Monday, March 12 with our special guests Brigid Leahy, Director of Legislative Affairs at Planned Parenthood of Illinois and a spokesperson from the National Women's Law Center, to talk about the recent attacks on women's health and how they fit into the larger strategy of balancing the inequalities in our current system of health care.

Call Agenda
- CBHC Executive Director Jim Duffett updates us on the status of Illinois' Marketplace (the insurance exchange.)
- CBHC Communications Organizer Kathleen Duffy will give an overview of communications plans for the anniversary of the Affordable Care Act on March 23, and for the Supreme Court hearings March 26-28.
- Our guest speakers will discuss the benefits of the Affordable Care Act for women, connect the dots about how attacks on women's health is really an attack on the Affordable Care Act itself, and describe how our efforts to build equity into Illinois' marketplace are good for women, minorities, and everyone.
- And as always, your questions and comments for all our speakers, taken and answered.

The Statewide Conference Call Series is a free resource for advocates presented by the Campaign for Better Health Care. Please visit this link to register and join us on Monday, March 12. Your questions for our speakers can be submitted ahead of time as well!

The Affordable Care Act: Fulfilling Promises, Cutting Costs

Did you know that the Affordable Care Act has alreadyexpanded affordable preventive health coverage to 54 million Americans?

If you’ve been following the Shriver Brief health care blogs, you probably remember reading about the Affordable Care Act mandate that insurance companies provide a specified list ofpreventive health care services to policy holders without charging a co-payment or deductible. Services like screenings for blood pressure and cholesterol; testing for Type 2 diabetes, obesity, and colorectal cancer; and alcohol and tobacco cessation counseling, among others are included in the mandate. Additional preventive health services like childhood immunizations; screenings for hearing, vision, and oral health; as well as testing for autism, HIV, and obesity, among others must be provided free of co-payment for children’s care. And starting in August of this year, insured women will be able to receive a set of women’s preventive health benefits like well-woman visits, FDA-approved contraception, mammograms, breastfeeding support and supplies, and domestic violence screening and counseling, also without cost-sharing. The health reform law requires that all of these free preventive health services are provided by insurance companies for anybody with a new or a so-called “non-grandfathered” insurance plan. And the mostrecent research shows that people—tens of millions of people—are already receiving these preventive services, for free!

According to a study conducted by the Kaiser Family Foundation, “31% of all workers were covered by plans that expanded their list of covered preventive services due to the Affordable Care Act.” Using this data, the Department of Health and Human Services (HHS) was able to calculate just how many people are benefiting from expanded preventive health coverage across the country.HHS estimates that 54 million Americans—and counting—have received one or more of the Affordable Care Act’s mandated preventive health services free of co-payment or cost-sharing. This number breaks down to over 20 million women, 14 million children, and 19.5 million men making use of their increased access to affordable and essential preventive health care. Illinois was among the top five states to benefit the most, with almost 2.4 million Illinois residents receiving free preventive health care services! And this number will only continue to grow as more and more people choose to enroll in new or “non-grandfathered” health plans, and as the health reform lawrolls out its final stages in 2014, adding 16 million individuals to the private health insurance market.

These kinds of meaningful, money-saving provisions in the Health Reform law are making a real impact at a time of need, when many individuals and families affected by the recession have been resorting to cutting back on basic medical care to make ends meet. A Kaiser Family Foundation study conducted in 2009 found that 53 percent of American families were cutting back on medical care because of the cost. In 2010, the Commonwealth Fund reported that 25 percent of Americans were cutting back on recommended tests like blood pressure tests, colonoscopies, mammograms, and other potentially life-saving cancer screenings. And just recently, a study from the University of North Carolina’s medical school found that, during the height of the recession, adults between the ages of 50 and 64 received 500,000 fewer colonoscopies compared to the couple of years before the economy turned, even though the colonoscopies can cut the risk of dying from colon cancer in half. The good news is the Affordable Care Act is increasing access to many of these preventive health tests and screenings at a price Americans can afford.

Households all over the country are pinching pennies trying to stay afloat during hard economic times. Thank you, Affordable Care Act, for working diligently to make sure that nobody’s health is sacrificed because of the cost of care.

Coauthored by Caitlin Padula and Rachel Gielau.
This post was originally published as part of The Shriver Brief's weekly “Did You Know” blog series, which highlights important, but not well known features of the health reform law about prevention, wellness, and personal responsibility for our health.

Using Technology to Connect in New Ways in Illinois

According to the Pew Internet & American Life Project, 85% of all Americans 18 years and older own a cell phone; of these users, nearly a quarter (72%) of them “text”. A July 2011 report shows that nearly one-third of all adults are “smart phone” users.

Given that these statistics are only likely to increase as technology becomes more advanced and allows us to get information in even smaller and more portable devices, it’s important to consider how technology help in efforts to share important and relevant information, as well as connect individuals with services that fit their needs.

For the past two years, Text4baby, the first ever FREE mobile health service, has been using cell phones to share health tips with pregnant women and new moms. Moms sign up by texting BABY to 511411 (or BEBE to 511411 to receive messages in Spanish) to receive helpful messages that are timed to their due date or baby’s first birthday. These messages include reminders about check-ups, immunizations, oral health, and tips for good nutrition.

We here at the Illinois Maternal and Child Health Coalition serve as the statewide coordinator  and have been working with health departments, community clinics, doctors’ offices, as well as local businesses to promote text4baby. To date, we’ve helped enroll nearly 13,000 users into text4baby and have made FREE outreach materials available for order from our website. We’ve heard firsthand from text4baby users about how direct and simple the messages are and how helpful they can be, especially for first-time parents.

Of the many useful messages provided by text4baby, several of them provide users with information about how they can get no-cost or low-cost health insurance for their children by providing them with the toll-free hotline 1-877-KIDS-NOW (1-877-543-7669).

Parents who call the 1-877-KIDS-NOW number in Illinois will be connected with the All Kids program, which provides affordable health insurance to children who live in Illinois and meet income requirements. Parents can request an All Kids paper application to be sent to their address or they can fill out the online application.

Nearly 1.7 million children in Illinois benefit from the All Kids program, which covers doctor visits, prescription drugs, hospital and emergency services, dental and vision care, and more. Some parents may qualify for FamilyCare coverage for themselves and pregnant women may be able to get benefits from the Moms & Babies program.

Even if text4baby or the All Kids or other health insurance programs may not be something that you need, consider sharing these resources on your Facebook page or sending out a Tweet to your followers about the benefits of these programs. With your help, we can ensure that more women, children, and their families have the best opportunity to lead healthy and productive lives.

This post, by Kathy Chan of the Illinois Maternal and Child Health Coalition, was originally posted on the MomsRising,org blog, here. 

The ACA Expands Preventative Care for 2,390,000 Illinoisans

To many, the cornerstone of the Affordable Care Act (ACA) is its  emphasis on providing Americans with access to important preventative care. The benefits of preventative care have been discussed in this blog before, in the context of chronic disease ,  breast cancer and  cervical cancer.

How exactly, then, is the ACA expanding access to preventative health care?

 One instance is a provision under the ACA that requires insurance plans[i] to provide important preventative health procedures to beneficiaries, without any cost-sharing measures (such as co-pays). The U.S. Department of Health and Human Services recently released information on how this provision will benefit Americans.

The list of important preventative health procedures was determined based on guidelines from the U.S. Preventive Services Task Force. Due to the ACA, children have gained access to regular pediatrician visits, immunizations, important vision and hearing screenings and developments assessments, as well as screening for obesity and counseling on how to maintain a healthy weight. Both men and women have gained  access to recommended immunizations and flu shots; cancer screenings (including colonoscopies and, for women, pap smears and mammograms); obesity screening and  healthy diet counseling; screening for high blood pressure and high cholesterol, depression and HIV; and tobacco use counseling. In addition, starting in 2014, women will be covered sexually-transmitted infection screening, and other services specific to women, such as gestational diabetes screening and contraception.

While many people with health insurance were already covered for these preventative health procedures, many were not: 31% of those who had health insurance through their employer have seen an expansion in their benefits—that’s 54 million Americans! In Illinois, the impact is among the biggest: 605,000 children, 898,000 women and 887,000 men have gained new access to expanded preventative health care. That is 2,390,000 Illinoisans, total, who have directly benefitted from the prevention expansions in the ACA!

I am proud to serve on the Administration’s Advisory Group on Prevention, Health Promotion, and Integrative and Public Health, established by the Affordable Care Act, where we will continue to develop policy and program recommendations, and advise the National Prevention Council on lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion

Barbara Otto

Health & Disability Advocates, Chief Executive Officer

---

[i] Excluding plans that have Grandfather status

Toward a More Inclusive, Healthy Union

Two and a half years ago Congressman Joe Wilson called out across the well of Congress, "YOU LIE, Mr. President." If the never-ending news cycles leave you struggling to recall exactly what President Obama was accused of lying about, it was the inclusion of undocumented immigrants in the yet-to-be-passed healthcare reform bill.

Thanks to this comment and the resulting uproar when healthcare reform begins in 2014 undocumented immigrants will be barred from purchasing healthcare on the regulated insurance exchanges -- even with their own money. They won't qualify for Medicaid, contrary to a popular myth. Moreover, many of their legal immigrant spouses, parents, cousins, etc. will also be ineligible for Medicaid. The unbelievably complex rules for immigrant healthcare could easily result in one family having their various members regulated by five separate sets of eligibility rules.

Eventually our nation will need to decide if we really want the people who clean our office buildings, care for our children, serve our food, and whose children attend school with our children to have significantly worse healthcare. Meanwhile, down in Florida, Governor Romney and Speaker Gingrich argue over the laughable notion of "self-deportation" and spar over who the anti-immigrant is.

But Illinois can move ahead, and make sure that healthcare reform is both rational and humane. While we cannot change the enormously complicated federal eligibility guidelines, we can reduce the confusion for families here in Illinois and promote healthcare access to the fullest extent possible.

We can ensure that immigrant families understand what their new healthcare options will be in 2014 by developing an infrastructure of community organizations to assist immigrants to understand their complicated eligibility and guide them towards other options if they don't qualify for or can't purchase health insurance. We must make sure we have a strong, stable safety net that includes not just preventative care but the acute care that left untreated results in high medical bills and throws many low-income individuals into medical debt and hurts our overall economy.

For all those who are still learning English, we can make sure the system supports provides language access so that patients can navigate their healthcare options. Finally, here in Illinois we've made a strong stand that all children should have access to healthcare. Let's keep it that way.

For more info on immigrants and the ACA, check out this IHM Resource.

Written by Joshua Hoyt, Director at the Illinois Coalition for immigrant and Refugee Rights. Follow Joshua Hoyt on twitter at www.twitter.com/icirr

This post originally appeared on the Huffington Post. 

New Rules Will Make it Easier for Consumers to Understand Health Plans

Last week, final rules were issued by the US Departments of Treasury, Labor, and Health and Human Services for the “Summary of Benefits and Coverage (SBC) and Uniform Glossary”. The SBC is a first step in consumer protection, but it also presents opportunities for advocates to get involved.


The Affordable Care Act requires new standards for use by health plans that “accurately describes the benefits and coverage under the applicable plan or coverage” and also calls for the “development of standards for the definition of terms used in health insurance coverage.” The final rule provides additional guidance to health plans that were developed through consultation with national experts and consumer-tested focus groups.

While this may sound complicated and boring, this rule is actually a great step ahead for health care consumers, and in particular, women, who tend to be the primary health care decision makers in families. Confusing language and lengthy, complicated forms make it difficult for consumers to make educated decisions about their plan selection and can lead to poor choices and coverage that doesn’t meet the health care needs of a family or individual.

A total of 12 required content elements are outlined in the final rule, including:
Uniform and standard definitions of medical and health coverage terms
Description of the coverage, including any cost-sharing requirements
Information about any exceptions, reductions, or limitations in their coverage

Plans will also be required to provide notices in a culturally and linguistically appropriate manner, but only when 10% of more of a county’s population is literate in the same non-English language. Currently, this only applies to 255 counties in the US, of which 78 are in Puerto Rico. HHS does plan to make available written translations of the SBC temple, sample language, and glossary in Spanish, Tagalog, Chinese, and Navajo. Advocates and community-based organizations should push plans to make information available in additional languages and continue to play a strong role in helping connect clients with information.

The SBC will also offer coverage examples that will help consumers understand how a plan will cover costs in particular situations, for instance normal delivery of a baby or managing type 2 diabetes.

SBCs will be required starting on the first day of health plans years beginning on or after September 23, 2012. The SBC cannot be longer than four double-sided pages in length and must be printed in 12-point font or larger. Consumers will access the SBC online and hard copies will only be available by request. This is a potential barrier for consumers and advocates should see this as an opportunity to push for broader distribution.

Check out the SBC template and glossary on the Center for Consumer Information and Insurance Oversight’s website and let us know what you think. Will you take the time to read these new forms when they are issued by your health plan? Are there still terms or phrases that are confusing? What can IMCHC and other advocates do to help consumers better understand their options?

This article was originally posted at Birth, Braces and Beyond, the Illinois Maternal and Child Health Coalition's blog. Feel free to share any comments with Kathy Chan, Director of Policy and Advocacy with IMCHC.

Health Reform's Best-Kept Secret

The Basic Health Program could bring more affordable, more reliable coverage to millions of adults--and improve access to care for children, too.

For all the attention devoted to the Affordable Care Act, scant consideration has been paid to a little-known part of it called the Basic Health Program. It's an option for states that could, if implemented nationwide, make health care coverage more affordable and accessible for more than 5 million adults and bring health coverage to more than 600,000 who would not otherwise have it.  Because many of these adults are likely parents of Medicaid- and CHIP-eligible children, the Basic Health Program could improve coverage and access to care for low-income children as well.

Most Say Ahhh! readers likely know how it works, but here's a quick recap of the Basic Health Program: under health reform, low-income people without health coverage will receive federal subsidies starting in 2014 to buy health insurance through Exchanges. States that implement the Basic Health Program in addition to an Exchange would contract with health plans or networks of doctors and hospitals to provide health care to people with incomes up to twice the Federal poverty line--just under $22,000 for a single adult--who don't qualify for publicly-financed programs such as Medicare or Medicaid. The Basic Health Program would replace subsidized coverage through Exchanges for this lower-income population. Washington would pitch in by providing states with 95 percent of the tax credits and subsidies that would have otherwise been provided through health reform.

According to an Urban Institute paper commissioned by our organization, the Association for Community Affiliated Plans, costs for subsidized health coverage through the Exchange are projected to cost low-income individuals more than $1,650 per year in premiums, copays and deductibles. For most people, that's a terrific deal. But for someone making $22,000 a year, $1,650 is nearly a month's pay. Many could well forgo coverage through the Exchange, pay a tax penalty of up to $700 and apply the difference to food, rent, or electricity. While health reform goes a long way towards making coverage more affordable through Exchanges and subsidies, health coverage may remain out of reach for some people with low incomes.

But if states were to implement the Basic Health Program to provide coverage modeled on Medicaid and CHIP, the Urban Institute estimates that annual premiums and out-of-pocket costs for adults would drop from a combined $1,650 to just under $200. At that level of affordability, paying the tax penalty makes no sense. The Urban Institute estimates that 600,000 people who would otherwise not purchase insurance would do so if all states ran a Basic Health Program. That's reason for cheer on its own.

Better still, the Basic Health Program could help more children access coverage and care in two ways. First, covering more adults will help children. While the Basic Health program would primarily cover adults in 2014 (Medicaid and CHIP handle low-income children), the lower premiums and reduced cost-sharing that could happen under BHP for adults would help children, as research has suggested a link between parents' insurance status and their children's access to care.

It could also serve as a backstop: should Congress not authorize new funding for CHIP in 2015, the Basic Health Program could serve as a bridge program for children, providing them with CHIP-like coverage rather than coverage through an Exchange. Finally, children who are prohibited from receiving Medicaid or CHIP coverage because of the 'five year bar' could be covered by the Basic Health Program. CHIPRA in 2009 gave states the option of covering these kids, but only six states had done so as of January 2011.

The Basic Health Program remains a work in progress, and there's work yet to be done: the Department of Health and Human Services must provide states guidance on several issues that will affect how states tailor their Basic Health Programs--notably, clarification of the mechanisms for calculating and delivering Federal funds. States must ensure that reimbursement levels for health plans and providers are high enough to attract an adequate number of participating physicians to meet demand for services generated by the program. While some analysts have questioned whether the Basic Health Program could adversely impact Exchanges, policy solutions could be found to address these impacts if they do occur.

The Basic Health Program represents the best health reform has to offer: more affordable and accessible care for millions of Americans, including parents and their children, and up to 600,000 fewer uninsured.

Given the financial pressures felt in statehouses across the country--and the professed desire by leaders on both sides of the aisle for affordable health options--the Basic Health Program deserves a long, close look. Governors, Medicaid directors and state legislatures across the country owe it to the people they serve to give Basic Health Program serious consideration.

Because this program is simply too promising to be kept a secret.

By Meg Murray and Jenny Babcock,Association for Community Affiliated Plans

This post originally appeared in Say Ahhh! A Children’s Health Policy Blog.