Communities of color, even once they have insurance, face barriers that can hinder access to those providers. Of those barriers, one of the most notable is the often limited availability of health care providers and facilities in communities of color. Today’s post outlines 10 tactics advocates can use to work with state and federal officials to help address these issues.
Last month, HHS and the Department of the Treasury issued new guidance on state innovation waivers that includes stronger protections for low-income and vulnerable consumers. We believe many of its provisions should be added to federal rules.
In November, the National Association of Insurance Commissioners (NAIC), the organization composed of insurance regulators from every state in the nation, will finalize a model law to help states ensure that consumers can get access to the right health care, at the right time, without unreasonable delay. Dubbed the Network Adequacy Model Act, this draft bill is designed to be used by any state to enact provider access standards for private health insurance plans.
While Congress wrestles with budget reconciliation and takes another swipe at the Affordable Care Act, most state lawmakers are back at their day jobs and finished with legislative business for the year. The 2015 sessions produced a few highlights, and some lowlights, for health care advocates. Lawmakers continued to grapple with full implementation of the ACA, but some looked beyond the health care law to move their states toward a health reform 2.0 agenda. Below we note some of the significant work this year in state capitals.
Much like a cell phone, an insurance plan is only as good as its network. Protections enacted at the federal and state levels are an important step toward strengthening private insurance provider networks. The Affordable Care Act created the first-ever provider network protections for private insurance consumers. These protections require health insurance marketplace plans to have adequate networks to meet their enrollees’ medical needs in a timely manner.
The Affordable Care Act (ACA) improved insurance affordability and access for all Americans, including those eligible for Medicare, Medicaid, and private coverage offered through the health insurance marketplace. It strengthened Medicare in many ways — by closing the Part D prescription drug doughnut hole, offering free preventive services, and extending the life of the Medicare trust fund. However, the ACA’s improvements to Medicaid and private market insurance highlight longstanding shortfalls in programs that assist low-income Medicare beneficiaries with their health care costs.
A recent, high-profile hospital acquisition in Massachusetts has sparked new debate about the continued trend toward consolidation among U.S. hospitals. Boston-based Partners HealthCare, already the largest health provider system in the state, made a bid earlier this year to acquire South Shore Hospital and its affiliated physician groups. An analysis of the proposed acquisition by the Massachusetts Health Policy Commission found that the merger could result in reduced market competition in the affected areas, leading to an increase in hospital charges of an estimated $23-26 million.
On April 13, 2012, the Congressional Research Service (CRS) published a report on the private market for long-term care insurance. The purpose of the report was to explore the reasons why people don't purchase long-term care insurance, but it also served as a reminder of how important Medicaid is for people who need long-term care.