The Families USA Health Action Team provides resources and consults on strategies for health care advocates around the country, working with our state and national partners. In this monthly blog, we’ll share news about our travels and progress on state policies.
As a freelance writer and director of a small nonprofit that provides expressive arts experiences to refugees in Tucson, Arizona, Marge is already very busy. But last year, Marge spent so much time trying to find a primary care physician in her health plan’s network that it began to feel like her third part-time job. Marge spent months calling doctors who were listed in her plan’s online provider directory, but this critical consumer resource proved to be inaccurate.
The Obama administration recently took steps to help people leaving prison or jail get health coverage more easily. Last month, the Centers for Medicare and Medicaid Services (CMS) released a long-awaited clarification regarding health coverage for people involved with the criminal justice system. Through this guidance, CMS seeks to expand health coverage options for those who’ve recently been released from incarceration.
Last week, CMS announced some changes to special enrollment periods for the health insurance marketplaces. We were disappointed to see that CMS is tightening the rules to allow for people who are moving permanently to qualify for an SEP.
To be eligible for the permanent move SEP, the new rule now requires consumers to have minimum essential coverage for at least one of the 60 days before they move. Previously, consumers could enroll upon moving without having prior health insurance.
As drug prices continue to rise at an unsustainable rate, we must ensure that our health care system and its financial incentives enhance the quality and value of care. We believe the Medicare Part B prescription drug model proposed by the Centers for Medicare & Medicaid Services (CMS) creates value for the patient and the program by encouraging treatment choices that have been shown to improve care and health outcomes.
The big news from Capitol Hill this spring comes courtesy of House Republicans, who are still mulling over plans to replace the Affordable Care Act. As we’ll explain, although no formal plan has been released, several harmful proposals have sprung up. But this spring also brought some fresh ideas from members of Congress that would, if passed, improve our health care system.
Covered California could be the first exchange in the country to sell health insurance to undocumented immigrants and Deferred Action for Childhood Arrivals (DACA) recipients. The state marketplace is trying to use a Section 1332 “state innovation” waiver to obtain federal approval for a plan to offer coverage to all Californians, regardless of immigration status. While the proposal does not allow undocumented people and DACA recipients to receive financial assistance to help them with the costs of insurance, it is an important step toward universal coverage.
Every day around the country, enrollment assisters help consumers get enrolled and stay enrolled in health coverage. This work provides assisters with a unique perspective on the consumer’s experience with the health care system. And it puts assisters in an ideal position to educate public officials about the enrollment process and to share their ideas for improving it.
Last Wednesday, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to implement key provisions of the Medicare Access & CHIP Reauthorization Act. Passed with bipartisan support in 2015, MACRA represents is an important opportunity to improve the quality of care delivered through Medicare. Given the number of people who are enrolled in Medicare and the number of providers who see Medicare patients, these changes will have a significant impact throughout the entire health care system.
On Monday, the Obama administration issued sweeping new standards for health insurers that operate Medicaid managed care plans for the states. The new rules are a big deal in part because they affect so many people: There are more than 72 million people enrolled in Medicaid.