In recent weeks, Republicans have released several proposals for replacing the Affordable Care Act. Ranging from op-eds to white papers to full-fledged bills, these plans share many ideas in common for how to replace the historic health reform law. The takeaway? Republican proposals would reverse the ACA’s extraordinary progress in helping millions of consumers gain access to affordable, comprehensive, high-quality health coverage. Here are six damaging ideas from the proposals we’ve seen to date.
More than 30 consumer groups, 37 senators, and 50 House members agree: Pregnant women should be allowed to enroll in health coverage when they find out they’re pregnant, even if it is outside the open enrollment period. Pregnant women who lack health insurance often go without necessary prenatal care, thus jeopardizing their health and that of their babies. Already, thousands of people have joined with the senators to call for the creation of a special enrollment period. Families USA has signed on as a partner in this effort, and we ask that you join us to demand access to health care for pregnant women.
Over the past two decades, state-based consumer advocates and health care practitioners have worked together to help low-income people—including those living in communities of color or with chronic medical conditions—gain access to health coverage. As more people gained insurance coverage, consumer advocates and health care providers focused their attention on improving the patient’s experience with the health care system.
Republicans swept the governor’s races last November, dashing hopes that those who opposed Medicaid expansion would be replaced in 2015. Instead, Republican governors put their alternative proposals on statehouse agendas in the South and the West, pitting them against GOP lawmakers. Some legislative sessions will be wrapping up this month and those Medicaid expansion proposals are generating some political battles, as you’ll see below.
It is often unreliable to assume predictions about Supreme Court case outcomes will be accurate. An obvious example occurred in the 2012 NFIB v. Sebelius lawsuit – the case challenging the Affordable Care Act’s (ACA) constitutionality. While the Court held that the overall ACA was constitutional, it, quite surprisingly, ruled that the Medicaid expansion mandate was not. Neither legal scholars nor those of us who heard the oral arguments predicted that outcome.
The plaintiffs in King v. Burwell are challenging the federal government’s ability to provide tax credits to consumers to help offset the cost of health insurance premiums in states that have not set up their own health insurance marketplaces (also known as exchanges) under the Affordable Care Act (ACA). The parties in this case are the government and the plaintiffs who claim that the ACA harms them. Those whose lives and livelihoods have been saved by the ACA’s premium tax credits have been left out entirely.
The second open enrollment period just ended—and it was a tremendous success. The fact that enrollment systems functioned much better this time around certainly made it easier for people to enroll. But there’s no doubt that the commitment and creativity of 23,000 certified application counselors, navigators, and in-person assisters across the country have made big contributions to enrollment gains. In this enrollment period, we saw navigators and assisters reach new heights of creativity as they strove to find consumers and help them sign up for health insurance.
The second open enrollment period in the health insurance marketplaces is officially closed. But HealthCare.gov and several state marketplaces are still accepting applications for coverage. These include California, Kentucky, New York, and Washington State—the four states participating in our final open enrollment teleconference call yesterday. The directors from these state-based marketplaces explained that the extensions are only for consumers who recently started an application to get health coverage but were not able to finish.
Around the country, health care advocates are developing advocacy agendas to ensure that private health insurance plans meet consumers’ needs. From addressing high costs for consumers to strengthening provider networks to improving prescription drug formularies, advocates have a lot of work planned this year to improve private insurance.
Here, we list some of the top private insurance issues that are on advocates’ 2015 agendas, along with best practices and resources that advocates shared with their peers at our Health Action conference:
One of the most significant and popular features of the Affordable Care Act (ACA) is the new protection that puts an end to insurance company discrimination against people with pre-existing health conditions. This important ACA protection depends on two other provisions that keep coverage affordable: premium subsidies and the coverage mandate.