Empowering patient voices through voter registration
While roughly 83% of adults in the United States will visit a health care provider in the next year, an estimated
News
9-27-12 Affordable Care Act Update
October 3, 2012
Federal Update
Beginning this week, all health insurers and group health plans are required to provide applicants and interested parties with an easy-to-understand summary of a plan's benefits and coverage. The summary must be provided during the plan's next open enrollment period. The new requirement is designed to help consumers better understand and evaluate their health insurance choices. The new forms include a short, plain-language Summary of Benefits and Coverage (SBC) and a uniform glossary of terms commonly used in health insurance coverage, such as "deductible" and "copayment."
All insurance companies and group health plans must use the same standard SBC form to help compare health plans. The SBC form also includes details, called "coverage examples," that allow consumers to see what the plan would generally cover in two common medical situations - maternity care and diabetes. ACS CAN is advocating for the inclusion of a cancer example in future versions of the form.
The SBC is modeled after the nutrition facts label required for packaged foods that enables consumers to make healthy and informed decisions about their diet. The SBC's standardized and easy to understand information about health plan benefits and coverage allows you to more easily make "apples to apples" comparisons among your insurance options. A consumer has the right to receive the SBC when shopping for or enrolling in coverage, or if he or she requests a copy from an insurer or group health plan. A consumer may also request a copy of the glossary of terms from your health insurance company or group health plan. (See attachment.)
SBC sample FINAL Sept 12.pdf
The SBC is a significant achievement, consistent with one of the Society and ACS CAN's "4 A's" of meaningful health coverage -- administrative simplicity. It is an important step in enhancing consumer awareness and understanding of health insurance. The White House received more than 3,000 communications from our dedicated volunteers in December insisting that consumers need access to comprehensible information to be able to make the most educated decisions they can about their coverage. In addition, ACS CAN Dr. John Seffrin personally lobbied the White House to enact the SBC in a timely manner and joined his counterparts from several other patient and consumer advocacy groups in a letter to the president arguing for a strong SBC regulation. The final product is in part the result of these efforts.
Read ACS CAN's media statement and my blog about the SBC. ACS CAN's Media Advocacy Team will be following up with ideas for promoting SBCs at the regional and local levels, once consumers start receiving them.
State Update
Many states are working right up to the October 1 deadline to make their decision on the benchmark plan the state will use as the minimum level of benefits that must be offered in all individual and small group health plans both inside and outside a state's insurance exchange beginning in January 2014.
Thus far, ACS CAN has assisted 16 states and the District of Columbia in submitting comments about the process of selecting a benchmark plan to define Essential Health Benefits. The states are Arizona, Colorado, Connecticut, Delaware, Hawaii, Kansas, Michigan, Mississippi, Nebraska, New York, North Dakota, Oregon, Rhode Island, South Carolina, Texas and Washington.
While the deadline for states to make a selection is rapidly approaching, it is possible that the Department of Health and Human Services (HHS) will allow more time for states that are close to finalizing the selection process. Any state that does not select a benchmark plan will automatically default to the benefit package of the state's largest plan in the small group market.
Even after states choose their benchmark plans, there is still be work to be done this year and next to ensure that cancer patients and survivors are assured of getting the care they need. The ACS CAN State and Local Campaign staff will be working with ACS CAN state staff in the coming weeks on a continuing strategy to help ensure that happens.
Health Care Law Saved Consumers an Estimated $2.1 Billion
The Affordable Care Act has saved consumers an estimated $2.1 billion on health insurance premiums, according to a new HHS report. New rate review rules in the health care law prevent insurance companies in all states from raising rates with no accountability or transparency. The health care law provides states with Health Insurance Rate Review Grants to enhance their rate review programs and bring greater transparency to the process. To date, rate review has helped save an estimated $1 billion for Americans. Additionally, the law's medical loss ratio provision -- or 80/20 rule -- is helping deliver rebates worth $1.1 billion to nearly 13 million consumers.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families.
Chris Hansen | President
ACS Cancer Action Network | American Cancer Society Cancer Action Network, Inc.