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Patrick McIntyre

By Patrick McIntyre

Health Care is Hard – Navigating the Changes

04/09/14


Health Care is Hard – Navigating the Changes main image

March 31 marked the close of the first year of Open Enrollment under the Affordable Care Act (ACA). And while the finally tally of total enrollments, and very importantly – previously-uninsured enrollments – continues, we do know a few things: United Ways, 2-1-1 Service Centers, and VITA sites helped thousands upon thousands of their neighbors navigate their health care options, and there’s more work to do to connect the millions of remaining uninsured Americans with coverage.

We also know a few other things: pre-existing conditions are now a thing of the past; consumers will no longer be subject to lifetime limits or annual caps; many prevention measures like mammograms and vaccinations will be provided by your plan; and the doughnut hole will close over time for seniors with prescriptions. These and other consumer protections are now required of every health insurance plan sold on each State’s Marketplace. And with an increase in competition on a more level playing field, greater Medicaid eligibility (in most states – more on that later), and with advanced premium tax credits, health insurance is now way more affordable for millions of Americans than it once was. In fact, about 50% of those under the age of 35 can find a plan for under $50 a month!

In the coming weeks, United Way Worldwide will capture some case studies of what worked and what didn’t work in terms of connecting consumers to coverage. Our goal is to learn lessons, share them with our state and local United Ways, our national and state partners, and with you!, and have an even more successful Open Enrollment in year two (November 15, 2014 through February 15, 2015).

In the meantime, other health policy issues remain. Almost half the states have chosen not to accept all of the Medicaid money allocated to them, leaving upwards of 5 million Americans uninsured who would be otherwise. In addition to the families who will not have the peace of mind that comes with having this health insurance in these states, hospitals, doctors and nurses, and other providers will not be appropriately compensated for the care they are required to deliver. Ensuring that every State accepts full Medicaid funding will go a long way towards affording health and financial security to low-income, uninsured working Americans… and to paying those medical professionals who take care of us.

And unless Congress acts, the Children’s Health Insurance Program (CHIP) could face some funding challenges in FY 2016 and beyond. Since its bipartisan inception in 1997, CHIP, together with Medicaid, has been enormously successful in covering kids. And because the Affordable Care Act is not perfect, CHIP is just as important as even in covering kids whose families could not afford private health insurance coverage otherwise. Educating Congress and governors of this future threat to CHIP will be an important endeavor this year in the lull between Open Enrollments.

So in short, there are lessons to be learned and improvements to be made, but this first year of Open Enrollment under the ACA has gone a long way towards reducing the number of Americans who are uninsured and connecting them to the care they need to heal, remain well, and remain financially secure. United Way looks forward to gleaning those lessons, applying them in the future, and delivering the peace of mind and opportunity that come with access to quality, affordable health care.

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