No, Health Reform Doesn’t Give Congress Special Treatment

Some health reform opponents claim the Obama administration is giving members of Congress and their staffs special treatment under the Affordable Care Act. The claim, which a number of media stories have repeated uncritically, is simply false: Although they will be required to enroll in health plans offered within the new health-insurance exchanges established under the law, members of Congress and their staffs will not receive extra financial help to pay for their medical care.

Critics are angry because the administration has confirmed that members of Congress and their staffs can continue to receive employer contributions to cover part of their premium costs. But that’s not special treatment. Today, most large employers do the same — the federal government, which provides coverage for members of Congress, their staffs and other federal employees, is no different.

In reality, it’s the critics — as part of their ongoing assault on the health care law — who are seeking special treatment for Congress, by proposing to make members and their staffs the only workers in the United States whose employer is barred by law from helping to cover their premiums. There’s no reason to discriminate against members and their staffs in this way, especially when doing so would make it more difficult to recruit and retain high-caliber congressional staff.

Here’s the issue: Under a provision authored by Sen. Chuck Grassley (R-Iowa) and added to the legislation during the Senate Finance Committee’s health care deliberations in 2009, members of Congress and their staffs won’t be allowed to continue buying coverage through the Federal Employees Health Benefits Program, which offers a variety of health insurance plans to federal employees. Instead, congressional staffers and members will only be able to enroll in plans offered in the ACA’s new exchanges, with the government continuing to make an employer contribution. (Grassley himself has confirmed that he intended for the federal government to continue making employer contributions under the provision.)

Critics claim this is special, gold-plated treatment because other people can’t get an employer contribution and use it to help buy coverage in the health exchange system. That’s incorrect. The ACA explicitly allows small businesses with fewer than 50 employees (up to 100, at state option) to offer their employees health plans through the exchanges and to help cover the premiums. This is essentially the same treatment that members of Congress and their staffs will receive.

Nor is the setup for Congress double dipping, as some mistakenly charge. Members of Congress and their staffs, just like the small-business employees, will be ineligible for federal tax credits to help cover the cost of their exchange health plans — unlike people with low and moderate incomes without employer coverage who buy health plans in the exchanges on their own.

There is one way in which health reform’s treatment of members of Congress and their staffs is unique — but it doesn’t involve preferential treatment. They are the only people in the country working for a large employer that is allowed to offer health plans exclusively through the exchanges. Unlike all other federal employees, they will not be able to enroll in plans offered through FEHBP. That’s because of the Grassley amendment.

Some members of Congress who oppose the ACA propose to prohibit the federal government from contributing toward the insurance premium costs of members and their staffs. Now that would be special treatment — the health care law does not prohibit the employer of any other workers in the country from making such a contribution.

If critics truly wanted to make sure there is nothing unique here, they would propose dropping the Grassley amendment and treat members of Congress and their staffs the same as other federal (and private-sector) employees, by allowing them to continue to enroll in plans offered through FEHBP, with the federal government continuing to make a contribution to help cover the costs. That’s how health reform treats other employers: It allows them to maintain current insurance arrangements and contribute on their employees’ behalf.

Why aren’t opponents of the health care law trying to do that? Presumably because there’s no political advantage in doing so. It’s time to get beyond political firefights and get on with responsible governing, including making health insurance coverage under the ACA work as effectively as possible for the American people.

Robert Greenstein is president of the Center on Budget and Policy Priorities

This post was posted first on Politico and reposted with permission from the Center on Budget and Policy Priorities.

ACA: More Than Just Healthcare for People With Disabilities

For people with disabilities finding a job has always been a one-two punch. It's not just the salary and financial independence they're looking for; they also are in greater need of health benefits than say, a nondisabled 30-year old.

October 1 marks the first day that people with disabilities can finally get both needs met. Under the provisions of the Affordable Care Act, many of the barriers to private health care for persons with disabilities will disappear. Americans can now shop for benefits in the new health insurance marketplace, for coverage beginning January 1, 2014.

For the first time ever, people with disabilities cannot be denied coverage due to a pre-existing condition, denied particular services or charged more for coverage based on their health status. Many health plans have to cover certain preventive services like routine vaccinations. And the ACA limits the ability of insurers to cap annual services on patients.

The ACA undeniably changes the paradigm for working-age people with disabilities, who now do not need to choose between healthcare and a job. If an employer doesn't offer insurance, the Marketplace will, with plans starting at less than $100 a month. No longer does a person with a disability need to rely on Medicaid, the free state healthcare program for low-income people where the income requirement is so stringent that not even a full-time McJob would be allowed.

The new law also takes some of the burden off employers, too. Employers hiring people with disabilities can be assured that rates will not rise. All health insurance plans will be required to offer a standard set of benefits like hospital care and doctors' visits, as well as cover services like medication, therapy and rehabilitation services, which people with disabilities need throughout their lifetime. There will be limits on rate increases and co-pays. Small employers with fewer than 50 full-time workers can also purchase coverage through the Marketplace.

What's more, 25 states and the District of Columbia have kicked in with their own programs to provide extra coverage to workers if the benefits a company offers are too "basic" for a person's unique disability needs. These special plans wrap around private employer-based coverage.

And an optional program known as Medicaid Buy-In allows workers with a disability in 42 states and the District of Columbia to retain Medicaid coverage and pay health premiums on a sliding fee scale based on their income. Medicaid buy-in programs are geared toward higher-paid workers, for whom a salary truly trumps federal assistance.

As always, our mission at Think Beyond the Label is to increase the percentage of working-age Americas with disabilities in the workforce. The ACA will help us to be more successful at connecting qualified workers to the employers that want to hire them. No longer will a job seeker need to ask: Does my employer offer insurance? Is the plan comprehensive enough to take care of my disability? Will my health needs be better met through federal and state programs that discourage work?

The ACA makes business and economic sense, too. Less reliance on federal disability insurance programs that limit work (and cost billions of dollars a year to run). Less concerns from employers -- especially small employers -- about how to pay for coverage for a person with a disability. More opportunity for all Americans to achieve financial independence and make a significant economic contribution -- to pay for important life goals like starting a family, buying a house and sending kids to college.

Though the law may have passed under President Obama, it was Ronald Reagan who asked, "How can we love our country and not...reach out a hand when they fall, heal them when they're sick, and provide opportunity to make them self-sufficient so they will be equal in fact and not just in theory?" The ACA does just this, providing an innovative approach that will give millions of people with disabilities a chance to live the American dream, without sacrificing their critical healthcare needs.

Barbara Otto

Principal, Think Beyond the Label

 Follow Barbara Otto on Twitter: www.twitter.com/@beyondthelabel 

This post was published first on the Huffington Post blog

Strong Interest in Illinois: State is Meeting Demand

 

Chicago – A stronger than expected showing for the Get Covered Illinois website, GetCoveredIllinois.gov, dominated the State’s storyline on the opening day of the Illinois Health Insurance Marketplace.  The following is an operational update:

WEBSITE:

The Get Covered Illinois website opened on time at 12:00 a.m. Monday, October 1.  As of 3:30 p.m. CST, more than 69,840 visitors had come to the online marketplace. 65,043 of them were unique visitors; and the page views totaled more than 412,580, with visitors viewing an average of six page views per visit.

“With a project of this magnitude, there was no accurate way to predict what our web traffic would be,” offered Jennifer Koehler, Executive Director of Get Covered Illinois. “But with that said, today’s numbers certainly validate the strong interest in healthcare in Illinois, and we’re glad to be able to service it. It also validates our strategy of education, since all this has come with basically no advertising. So we are overall very, very pleased.” 

Only a handful of early and minor glitches were reported, impacting a very limited number of consumers. All minor glitches were reported and fixed by early afternoon. “The site has performed incredibly well, the way we designed it to,” added Koehler. 

Additionally, the State received more than 1,100 online applications submitted on the ABE (Application Benefits Exchange) portion of the Get Covered Illinois site. 

HELP DESK:

The Help Desk received more than 350 calls as of 3:30 p.m.  Calls were answered in an average speed of six seconds, and callers were on line with Help Desk specialist an average of six minutes.

FIELD OPERATIONS:

There is steady interest, as judged by customers at our grantee community organizations today.  Most consumers are reportedly doing exactly as State officials hoped – coming in to be introduced to the process, the website, the Navigators and making appointments over the next few weeks as they become educated themselves on the site, and come back with prepared questions, and more ready to enroll.

“We know this is not nearly the same as buying a gallon of milk, a new pair of shoes, or anything in daily life,” said Director of Outreach Brian Gorman.  “Shopping for health insurance is brand new for more than a million Illinois residents, and it will take education and time to get comfortable with this new process.  But we are thrilled to see, today that process of understanding the right plan for them and their families started in earnest in locations all across Illinois. Consumers responded to our ask – which was to meet their community partners, understand the resources available and get an appointment when they are ready to get covered.” 

SOCIAL MEDIA:

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Posted with permission from GetCoveredIllinois.gov

If You Have Medicare, No Need to Go to Insurance Marketplaces

BULLETIN TODAY | PERSONAL HEALTH

By Susan Jaffe, Kaiser Health News. This story produced in collaboration with USA Today. 

This post is courtesy of AARP's blog. 

While the Obama administration is stepping up efforts encouraging uninsured Americans to enroll in health coverage from the new online insurance marketplaces, officials are planning a campaign to convince millions of seniors to please stay away – don’t call and don’t sign up.

“We want to reassure Medicare beneficiaries that they are already covered, their benefits are not changing and the marketplace doesn’t require them to do anything,” said Michele Patrick, Medicare’s deputy director for communications.

Learn how the new health law works for you and your family

To reinforce the message, she said the 2014 “Medicare & You” handbook – the 100-plus-page guide that will be sent to 52 million Medicare beneficiaries next month — contains a prominent notice: “The Health Insurance Marketplace, a key part of the Affordable Care Act, will take effect in 2014. It’s a new way for individuals, families, and employees of small businesses to get health insurance. Medicare isn’t part of the Marketplace.”

Still, it can be easy to get the wrong impression.

“You hear programs on the radio about the health care law and they never talk about seniors and what we are supposed to do,” said Barbara Bonner, 72, of Reston, Va. “Do we have to go sign up like they’re saying everyone else has to? Does the new law apply to us seniors at all and if so, how?”

Enrollment in health plans offered on the marketplaces, also called exchanges, begins Oct. 1 and runs for six months. Meanwhile, the two-month sign-up period for private health plans for millions of Medicare beneficiaries begins Oct. 15. In that time, seniors can shop for a private health plan known as Medicare Advantage, pick a drug insurance policy or buy a supplemental Medigap plan. And in nearly two dozen states, some Medicare beneficiaries who also qualify for Medicaid may be choosing private managed care plans. None of these four kinds of coverage will be offered in the health law’s marketplaces.

Since many of the same insurance companies offering coverage for seniors will also sell and advertise policies in the marketplaces, seniors may have a hard time figuring out which options are for them.

“Over the next six months seniors will be bombarded with information and a lot of it will be conflicting and confusing,” said Nick Quealy-Gainer, Medicare task force coordinator for Champaign County Health Care Consumers, an Illinois advocacy group.

“Every time there is publicity about the marketplaces, our calls spike,” said Leta Blank, director for the Montgomery County, Md., State Health Insurance Assistance Program.

While Medicare officials steer seniors away from the marketplaces, there is nothing in the health law that prevents beneficiaries from signing up for markertplace plans, said Juliette Cubanski, of the Kaiser Family Foundation. If they do, they will not qualify for premium tax credits for the marketplace plans. (Kaiser Health News is an editorially independent program of the foundation.)

These plans may appeal to wealthy seniors – about 5 percent of Medicare beneficiaries — who pay higherpremiums for Medicare based on their income and assets, said Cubanski. But for the vast majority of seniors, she said, Medicare’s benefit package is better and more affordable compared to marketplace coverage.

Confusion about different government health programs could also create opportunities for scams.

In Denver, AARP officials received complaints from seniors who were told they would lose their Medicare coverage [pdf] if they did not divulge their Social Security numbers and other confidential information needed for their new “national health insurance card” under the Affordable Care Act. The Federal Trade Commission issued an alert about such scams in March.

“One of the things we are paying special attention to is fraud prevention messages,” said Medicare’s Patrick. Seniors can be particularly vulnerable to scams “but with all of the changes in the health care landscape, we may need to be even more careful this year.”

Some Questions From Seniors About Medicare And The Health Marketplaces: 

• Will I lose Medicare coverage? No.
• Do I need a new Medicare card? No.
• Do I have to re-enroll in my Medicare Advantage or supplement plan through the marketplace? No, these policies are not sold in the marketplaces.
• Will seniors in Medicare have to buy supplemental insurance? No.
• Will they be fined if they don’t buy coverage in the health marketplaces? No, as long as seniors have Medicare Part A, which is free and covers hospitals, nursing homes and hospice. [They] already have insurance, so they are not subject to the penalty that most uninsured adults under 65 will have to pay.

Do we Have to Cancel Obamacare to Keep the Government Running? No.

Last Friday, the House voted — yet again — to defund the Affordable Care Act, aka Obamacare. In a creative twist, Republicans tacked the anti-ACA language onto the Continuing Resolution that provides funding to keep the government running.

What does this mean?
Continuing Resolutions are the stopgap funding mechanisms that Congress has been relying on since the sequester started, to keep programs running in the absence of traditional appropriations measures. The resolution must pass both houses of Congress, in some form that is acceptable to both.

So what will happen next is that the Senate will snip out the offending defunding language and send a "clean" version of the measure back to the House. Speaker Boehner could then bring it to a vote — thereby annoying the party's right wing — or majority leaders may try a slightly modified tack, perhaps finding some other aspect of the ACA law to challenge in the version they send back. It could bounce back and forth several times this way.

The deadline for the current Continuing Resolution is October 1st; if it is not passed by then, parts of the government will start to shut down. In particular, these will be the parts that are heavily dependent on year-to-year appropriations, such as the National Institutes of Health and the FDA. Cancer research could be jeopardized, drug approvals slowed, Social Security checks delayed due to staff being furloughed.

Won't shutting down the government bring Obamacare to a halt as well?
Not really, because the vast majority of the funding for implementation falls outside the annual appropriations process. In fact, on July 24, the Congressional Research Service responded to an inquiry from Oklahoma Rep. Tom Coburn on this very question, saying that by and large ACA implementation would be unaffected. Here are some of the highlights:

• Medicare claims are paid from the Medicare Trust Fund, not annual appropriations
• Changes to Medicare and Medicaid law are already in place
• Many of the implementation grants to states have already been made
• The IRS would continue to collect taxes and user fees
• The individual mandate and health consumer protections are already in place (as matters of law, not funding)
• Even in a "shutdown" there are provisions for essential services to continue

The full report is available here.

Last Friday's action was the 42nd time that congressional Republicans have voted to defund the ACA, and it is not the first time a government shutdown has been threatened. In 2011, a shutdown was narrowly averted, leading to the current "sequester." And the 1995-96 federal budget debates actually resulted in 28 days without non-essential services. Government funding is, in fact, only half the story; there is also the debt ceiling. In October, the nation's debt ceiling must be increased so that national bills can be paid. Failing to pay the already-accrued bills of the United States would have worldwide economic consequences. But the president has made it clear that he will not negotiate on the debt ceiling.

And what is our role, here on the ground?
Since there is no chance that the Senate will approve ACA defunding, the new approach, said Illinois Congresswoman Jan Schakowsky, will be to sow confusion. For example, there is already a major campaign to try to get young people not to enroll.

And that is why it is so important to get the word out. "We need to reach everyone," she said. "We have a week until launch day. But we have six months to get people enrolled." Rep. Schakowsky keeps an Obamacare Toolkit updated on her website. Rep. Schakowsky was a featured speaker at Monday's Statewide Conference Call Series organized by the Campaign for Better Health Care; the call focused on issues surrounding the threatened shutdown.

"One reason the Republicans do not want the ACA to go into effect is that they are assuming it will work," said Jennifer Beeson, Director of Government Relations at Families USA, another featured speaker. "Success is what will stop them."

But "we must remember how confused the American public is about this law, " said Beeson. "Many aren't even sure it's law." But "the law is real. It is in every state." The Families USA site features a Health Reform Central and state-by-state information.

The best time to reach people, Beeson noted, is when they are ready to take action — which is why the days ahead are so important. Starting next Tuesday, when people can go out and find out what is available to them, HHS will be doing targeted messaging to eligible groups; health districts and hospitals will have people available to counsel individuals; organizations and libraries will hold informational sessions. And we need to be ready on the ground with detailed information to provide outreach.

"Despite the obstructiveness and the rancor," said Rep. Schakowsky, "we are at the threshold of a very great moment."

Nina Sandlin
Guest Blogger for Health & Disability Advocates

What Could Be More Important than October 1, Right?

Written by Ryan Singleton    October 1, 2013—the date’s been circled on our calendars for months. We’ve talked about it inpodcasts and spilled ink over it on our blog. October 1, 2013, is opening day for health insurance marketplaces, which are online destinations that will allow consumers to shop for and compare insurance under our reformed health care system.Sounds great, right? Of course, it does! It brings choices to consumers and theoretically gives more people access to affordable, quality health insurance. For years, the AIDS Foundation of Chicago (AFC) has been advocating for a more just health care system for people living with HIV/AIDS – and anyone in need of health care – and this is a gigantic step forward. Perhaps that’s why there’s so much frustration. October 1 is less than two weeks away, and most states—including Illinois—still haven’t launched their marketplaces or finished training in-person counselors, who are people designated to help individuals navigate insurance options online. To gain a nuanced perspective on the coming marketplaces, Inside Story sat down with John Bouman, president of the Sargent Shriver National Center on Poverty Law, a national organization that advances laws and policies that secure justice to improve the lives and opportunities of people living in poverty. Inside Story: A lot of people contact AFC about Illinois’ insurance marketplace, asking, “When will the site go live? Where can I find the web address?” The only answer we have is, “We don’t know,” which leaves people frustrated. Many know that marketplaces can’t sell insurance until October 1, but they still want to see the site in order to formulate questions for in-person counselors and to have reassurance that they’ll have health insurance in 2014. John Bouman: We have to keep the national picture in mind. People will want to use the frustrations and advocacy around the implementation to fuel the effort to de-fund and undo the whole ACA. We have to be careful that our legitimate advocacy around implementation issues is not used for that purpose. This means strong advocacy with the system but careful handling of the big public message—don't forget the thousands who do enroll and don't have problems. IS: What happens if October 1 comes and goes, and our marketplace system isn’t functioning smoothly or even worse, isn’t live yet? JB: October 1 is the opening date for enrollment. Coverage doesn't start until January 1, and people can enroll until March 31 and still be covered in 2014. So, the long-awaited October 1 live date for the website and enrollment is not paramount. January is. In the interest of paying attention to my previous point, we can have some patience with the start-up delays and inevitable glitches, mistakes, and other issues. Moreover, we have to contribute to an over-arching message that implementing something of this size inevitably has some start-up problems. This is normal stuff, and we're working on it. But it does not mean that the underlying policies are wrong or not worth their funding. Illinois authorities have also done their best to plan ahead, but more importantly they have been paying close attention to feedback from communities and acting quickly to correct mistakes or unanticipated issues. IS: Is there anything we, as general consumers, can do to make sure health care reform can make the greatest, positive impact? JB: Yes, for sure, we have to push hard to identify all the problems in this new system, so that we can pressure the state to fix them. If somebody discovers an issue, please contact Molly McAndrew, Program Manager for AFC's In-Person Counselor Program, at MMcAndrew@aidschicago.org. Courtesy of AIDS Foundation of Chicago. John Bouman, president of the Shriver Center, is widely recognized as one of the most effective and thoughtful public-benefit advocates in the country. He was a leader in the design and implementation of positive aspects of Illinois’ new welfare law in 1997, and he spearheaded the statewide efforts in Illinois to create both the FamilyCare program, which provides health care insurance for up to up to 400,000 working poor parents of minor children, and All Kids, the first state plan to extend health coverage to every child. Click here to read his full bio.

CBHC Reaction to U.S. Census Bureau 2012 Health Insurance Status Data

September 17, 2013

 

 

Statement by Jim Duffett, Executive Director, Campaign for Better Health Care, on U.S. Census Bureau 2012 Health Insurance Status Data

 

This morning, the U. S. Census Bureau announced findings from the official report on income, poverty and health insurance coverage for the nation.  The news, as expected, was not great.  There are still too many Americans who do not have the peace of mind that comes from knowing that they and their families will be able to obtain quality, affordable health care when they need it. 

The good news is that thanks to the Affordable Care Act, this is the last year in the history of our nation we will ever see such high numbers of uninsured Americans. Starting with next year's report, these numbers will shrink by tens of millions as more Americans are covered because of all the different consumer protections and eligibility expansions contained in Obamacare. 

The numbers will get smaller as more young adults stay covered on their parents' insurance plans through age 26, protecting them through the  period of time between graduating college and finding work in a challenging job market.  More Americans will be insurable despite their pre-existing conditions.  And as more small businesses qualify for tax credits that allow them to offer health insurance coverage to their employees, yes - those numbers will keep going down.

Millions of Americans who will find coverage through the new Marketplace will know it is they that are in charge of their health care, not the insurance industry.  Millions of Americans will know peace of mind, the power of choice, personal responsibility, and fairness; all the values that we attach to health care will finally be realized.  Those are the numbers that we look forward to seeing increase over the next few years, thanks to Obamacare.

 

# # #

 

About Campaign for Better Health Care

We believe that accessible, affordable, quality health care is a basic human right for all people.  The Campaign for Better Health Care is the state's largest coalition representing over 300 diverse organizations, organizing to help create and advocate for an accessible, quality health care system for all.  For more information, visit  www.cbhconline.org.