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3-14-14 Affordable Care Act Update
March 14, 2014
State Update
Washington State Legislators Propose Improved Network Access Standards
Washington state legislators are using state rulemaking to better define provider network access standards required under the ACA. The proposed rule creates access standards for plans and makes tiered provider networks more patient-friendly. It specifically addresses geographic proximity requirements between patients, health care providers and health care facilities; and defines how plans must ensure provider access to rural areas. ACS CAN has submitted comments on the proposed rule and is working closely with the Office of the Washington Insurance Commissioner to ensure that the final rule provides cancer patients with essential access to oncology specialists.
California Bill Aims to Increase Transparency of Drug Coverage
California’s legislature is finalizing a bill that would require greater transparency around drug coverage for plans sold in the state’s marketplace. Currently, cancer patients shopping for a plan on California’s exchange have trouble determining whether or not a plan will cover their cancer treatment drug and, if so, how much it will cost.
Under the proposed legislation, insurance carriers in the state exchange will be required to:
- use a standard formulary template to display all drugs covered under each plan;
- disclose both prescription drugs and physician-administered drugs covered;
- assign each drug a dollar range reflecting a patient’s monthly out-of-pocket expense; and
- provide a PDF of the formulary with an easily accessible link on their website.
New Hampshire Senate Approves Access through Medicaid
The New Hampshire Senate reached a deal last week that will broaden access to health care through Medicaid for as many as 58,000 additional residents. . The bill now moves to the lower chamber, which overwhelmingly approved a similar package in November. The measure is expected to be passed by the House at the end of March. Governor Maggie Hassan, who has already affirmed her support, is expected to sign the bill.
Media Update
ACS CAN to Co-Host ACA Twitter Chat
ACS CAN is joining the American Heart Association and Autism Speaks to host a Twitter chat Wednesday, March 19th at 2pm ET. The chat will highlight ACA provisions that are giving people with cancer and their families greater access to quality, affordable health coverage. We invite you to follow the chat (hashtag #ACAchat) from our Twitter handle @ACSCAN and promote it in advance among your contacts.
ACS CAN Volunteer Authors Column on Patient Protections
ACS CAN volunteer Amy Wilhite authored a column on the Cleveland Plain Dealer’s website this week that emphasized the importance of critical patient protections in the ACA. Wilhite, who is from Marblehead, Ohio, shared her family’s story about the impact that the law’s elimination of arbitrary limits on coverage has had on her daughter Taylor’s health and her family’s finances. “Thanks to the health care law, being sick or injured doesn’t mean your coverage can end at a moment’s notice, or that you can be denied coverage altogether,” Wilhite said. Her story is one more example of how ACA provisions that ACS CAN fought to include in the law are improving access to lifesaving coverage.
Many Underestimate Price of Penalty for Going without Health Insurance
NPR reports that many Americans underestimate the tax penalty they will face if they do not obtain health insurance by March 31. Health policy experts remind individuals and families that “the penalty is the maximum of either $95 or 1 percent of taxable income in 2014.” In many cases, 1 percent of income may be much higher than $95. And even for those with more modest incomes, it’s important to note that the penalty will be assessed for each family member who lacks health coverage.
ACA Cited as Uninsured Rate Drops
The Gallup-Healthways Well-Being index released this week finds that 15.9 percent of U.S. adults are uninsured so far in 2014, down from 17.1 percent in the last quarter of 2013. The Associated Press reports that the proportion of U.S. adults who are uninsured is on track to reach the lowest quarterly level measured since 2008, and states that it’s a “reasonable hypothesis” that the ACA has contributed to the drop. The index also shows that almost every major demographic group made progress acquiring health insurance, although sign-ups among Hispanics continues to trail other groups.
Resource Highlights
As mentioned in last week’s update, the March 31 enrollment deadline has heightened attention to the ACA this month. Below is a quick reference for resources that help educate people with cancer and their families about the law’s patient protections.
The Health Care Law: How It Can Help People With Cancer and their Families – The Society’s consumer-friendly guide to the ACA is available in print from Society Mart (item #5600.00).
Ley de Atención Médica: Cómo esta ley puede ayudar a las personas con cáncer y a sus familias – The Spanish language version of the ACA consumer guide is available from Society Mart (item #5600.10).
fightcancer.org – ACS CAN’s website offers a variety of resources to educate patients about the ACA
FinancialHelpforHealth.org – This new website from the Robert Wood Johnson Foundation explains the financial help available under the ACA and sends consumers to their state’s online marketplace.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families. If you have any questions, please don’t hesitate to contact Carter Steger, Senior Director, State and Local Campaigns, at [email protected], (202) 661-5727, or Keysha Brooks-Coley, Director, Federal Relations, at [email protected], (202) 661-5720.
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Chris Hansen | President, ACS CAN |