Health Care Reform

The Affordable Care Act

Latino Meeting

First Meeting of a Latino group discussing health care issues.

 

Obamacare
The Affordable Care Act (ACA), also known as Obamacare, has already made many changes that help consumers of health care:

  • Children under 26 years of age can stay on their parents’ insurance plans whether they are in school or not.
  • People who have Medicare can now get an annual physical with no co-pay. Previously, Medicare only paid for acute illnesses.
  • The “Doughnut Hole” is gradually being eliminated saving money for seniors with many prescription drug costs.
  • Insurance companies can no longer put a cap on the amount of money they will pay for medical claims.

Beginning January 1, 2014 the most extensive parts of the ACA will kick in. Among the changes are:

  • All individuals who have no health care insurance are required to purchase insurance.
  • Connecticut has an Exchange, called Access Health CT, through which people can see all the policies that are available to them and to sign up for the one they like best.
  • There are subsidies and tax breaks from the federal government for anyone who cannot afford to pay the full premiums, deductibles and co-pays.
  • Medicaid eligibility has been expanded so that more Connecticut residents can enroll in this health care insurance program.

For more detailed information go to:
www.healthcare.gov
www.accesshealthct.com

What is CFC Doing?
CFC is monitoring the implementation of the ACA and Access Health CT. Among the concerns of CFC:

  • How to make sure that policies sold through the Exchange are affordable!
  • How to make sure that the process for signing up for Medicaid on the Exchange does not involve the problems that people have continuously faced when applying through the Department of Social Services (DSS).

Health Care reform is happening at a rapid pace in Connecticut. Some of the reforms are part of the Affordable Care Act (ACA), some are initiated by the State of Connecticut and others are the result of changes being made by providers and insurance companies. Some of the changes that consumers of health care are interested in include:

1)      Medicaid Expansion: Under the ACA states can expand Medicaid coverage to people whose monthly income is below 133% of poverty or $1,273 for an individual. In Connecticut that means that thousands of adults with no children will be able to get Medicaid for the first time. Previously the monthly income limit was $507. Starting January 1, 2014 thousands of people will become eligible for HUSKY D.

2)      Medical Homes: This reform puts a lot of emphasis on preventive care and the coordination of all care by the primary care physician. Elements of this model include electronic record keeping and the aggressive treatment of chronic diseases like diabetes and heart disease. For more information go to Medical Homes.

3)      Payment Reform: Currently, most physicians are paid on a fee-for-service basis. That means that they are paid separately for each service they provide. Under this system there is an incentive to add more services, tests, etc. There are lots of experiments taking place that will change the way providers of health care are paid.
The State of Connecticut has received a grant from the federal government to develop a plan for payment reform in Connecticut. This effort called SIM (State Innovation Model) has submitted a plan to the federal government. A description of the plan is available at http://www.healthreform.ct.gov.

 What Can You Do?

If you have a problem using the Exchange (Access Health CT), or if you would like to work with CFC monitoring implementation problems, contact CFC at 860-524-0502.

You can:

  • Join a CFC Leadership Team to plan strategies
  • Attend CFC events
  • Speak to your legislators about health care issues
  • Write letters and/or e-mails to elected officials and administrators
  • Talk to your friends and neighbors about joining CFC