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Thursday, February 4, 2016

Health Action Highlights: Day 1

On the first day of Health Action 2016 speakers reminded us about the collective action that fueled the passage of the Affordable Care Act—and that this same type of collective action will be necessary to tackle the health care and coverage challenges that remain. These include covering the undocumented and making coverage more affordable. Scroll down to read some highlights in chronological order and search #HA2016 to join the conversation on Twitter.

2 p.m. Measuring Success in Medicaid Expansion workshop

Patricia Boozang, Manatt Health Solutions
Emily Beauregard, Kentucky Voices for Health
Cara Stewart, Kentucky Equal Justice Center

States advocates like Emily Beauregard and Cara Stewart in Kentucky have undertaken the major feat of illustrating their state’s positive economic impact from expanding Medicaid. Kentucky’s newly elected governor, Gov. Matt Bevin, plans to reform the state’s Medicaid program. Beauregard and Stewart worry that in addition to this decision, Gov. Bevin will lead the state way from its state-based marketplace (Kynect) to offer health plans in the federally facilitated marketplace. 

Patricia Boozang of Manatt Health Solutions worked with eight states (and will add an additional four states to this list) to determine how Medicaid expansion affected each state’s savings. In the case of Arkansas and Kentucky, she concluded that these states’ savings and revenue gains would offset the cost of expansion at least through 2021. 

Other areas most significantly affected by savings from expanding Medicaid include: 

  • The medically needy population. This group is determined ineligible for traditional Medicaid and can use this program to get care. They are high-cost consumers who typically cost the system the most. Expanding Medicaid has saved states millions of dollars when it comes to their medically needy populations. 
  • Reductions in uncompensated care. 
  • Rural hospitals. They are doing better overall in Medicaid expansion states.
  • Mental health and substance abuse services. Michigan saw huge savings related to behavioral health services, Boozang said. These are services outside of the Medicaid budget, but their overall savings contribute to a healthier state base.
  • Corrections systems. This is another significant area of savings. Because Medicaid covers care for incarcerated people, Boozang said that the savings to the states’ correction budgets have been extraordinary. 

Boozang emphasized how important it is to recognize that so many people who would benefit from Medicaid expansion are actually working people

12: 15 Health Care for All – Expanding Access for Immigrants

Bob Ross, The California Endowment
Marielena Hincapié, National Immigration Law Center

Bob Ross and Marielena Hincapié outlined the next big step in health access: extending health coverage to the undocumented. 

Ross described how TCE approached creating a campaign to build support for health coverage for the undocumented. They funded the Health4All campaign, focusing on people power. The campaign has yet to win coverage for all undocumented, but last year they won full health coverage for undocumented kids

Hincapie reminded the audience that illnesses do not see papers. There is nothing worse than being undocumented and uninsured. She called the exclusion of the undocumented from the ACA shameful.

“As long as policymakers continue to exclude segments of people, it undermines our vision for true health for all,” she said.

10:45 Damn Those High Deductibles

Alda Rivera, SRA International
Lydia Mitts, Families USA
Arlene Murphy, Access Health CT

High deductibles don't make consumers better health care shoppers, but do block them from services, said Families USA’s Lydia Mitts. She noted that one of the most alarming consequences of the increasingly common high-deductible health insurance plans is that consumers stop using services they need: diabetes medications, statins, and hypertension medication. 

What solutions can advocates push for Standardized plans offer potential for addressing some of these problems. The new CMS proposal is pretty progressive, Mitts said, compared with the trends in the marketplace. 

Another promising solution lies in Value Based Insurance Design: Plans cover care pre-deductible that is universally agreed to be of high clinical value, like diabetes medication. Some state plans are already doing this.

Arlene Murphy, Access Health CT, described her state’s experience in developing the silver standard plan and how they were able to involve consumers in this process. She shared details about how they managed to exclude many important services from the deductible to make care more affordable.

Sophie Stern, Enroll America, described the challenges of communicating to consumers during enrollment sessions about complex cost-sharing information. 
It’s not enough to focus just on the deductible with the consumer, said Stern. You have to explain how other cost-sharing features work. You need to look at each person’s individual situation and ability to pay monthly or handle unexpected costs. This is why they created their plan explorer. 

8:30am Opening Plenary

Families USA’s Executive Director Ron Pollack welcomed nearly 600 attendees to the 21st annual Health Action conference bright and early this morning. On the heels of the end of OE3, Health Action 2016 is bringing together enrollment assisters and health care advocates to talk about the biggest issues facing health care consumers this year. 

“Will we make progress expanding Medicaid in the 19 remaining states?” Pollack asked. “Will the critical safety net be strengthened or undermined? How will we make life-saving medicines affordable? And will we strengthen the enrollment infrastructure that so many of you are a part of?”

These are some of the core questions we’ll discuss at this year’s Health Action conference. 

Surgeon General, Planned Parenthood chief, and key lawmakers reflect on achievements of the ACA and work left to do

Rep. Melissa Lujan Grisham, a Democrat from New Mexico, spoke about the strides her state has made in reducing the number of uninsured people. She also praised her Republican governor for expanding Medicaid shortly after winning office. 

Thanks to the ACA, “being a woman is no longer a pre-existing condition in America,” said keynote speaker, Planned Parenthood’s Cecile Richards. They can longer be denied coverage because they are pregnant or have breast cancer.

Planned Parenthood health centers play a critical role in enrolling people in marketplace coverage and making sure people understand their new health insurance benefits after they sign up for coverage. 

Rep. Luis Gutierrez of Illinois emphasized that when everyone—including women and minorities such as immigrants—has health insurance, it strengthens the health of our national overall. But we still have a ways to go in making our health system accessible and affordable for everyone. 

“You, as advocates, have to put pressure on Congress to reform,” said Grisham. “We need to keep premiums affordable, and we need to have legitimate conversations about how to protect our economic future.” 

When it comes to surprise medical bills, Grisham emphasized that the burden should not be on the patient to figure out what’s going on. Transparency remains a concern as consumers try to navigate a complicated system. That’s why Rep. Lloyd Doggett of Texas introduced new legislation to protect consumers from surprise medical bills or “balance billing.” 

“We’re trying to lay the groundwork for the future,” said Rep. Doggett.