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Affordable Care Act (ACA)

Health Barriers and Breakthroughs for LGBT People and Individuals Living With HIV/AIDS

Last week, HHS released its third annual report outlining its accomplishments over the past year and its objectives for the coming year for improving the health of LGBT individuals, families, and communities. LGBT women in particular have reason to celebrate these accomplishments, but all women benefit from initiatives that seek to end discrimination and improve health outcomes and health care access.

For example, HHS regulations and guidance requiring equal visitation rights at hospitals, nursing homes, and other facilities that receive Medicare or Medicaid helps not only LGBT families but also anyone who has a family joined by bonds of affection and affinity rather than legal coupled status. Likewise, the ACA’s nondiscrimination protection (section 1557) provides important protections against discrimination for women and LGBT people alike.  HHS’s focuses in the upcoming year—implementing the ACA and the June 2013 Supreme Court decision striking down a part of the Defense of Marriage Act (DOMA)—have important gains for women, LGBT people, and individuals living with HIV/AIDS. Read more »

Reproductive Justice for All – Including Students at Georgetown

I, like many other Georgetown students, let out a sigh of relief upon reading the most recent e-mail from President DeGioia. This e-mail announced that contraceptive coverage would be available to everyone on the University’s insurance plan with no additional cost to them or the University. This controversial change in Georgetown’s insurance policy is occurring thanks to the new health care law which is officially titled the Affordable Care Act, which requires employers to provide contraceptive coverage.

Regulations finalized by the Obama Administration in late June declared that the insurance companies themselves must pay directly for contraceptive services for those at non-profit organizations that oppose providing contraceptive coverage on religious grounds, such as Georgetown. DeGioia believes that these regulations “give us the opportunity to reconcile our religious identity and our commitment to providing access to affordable health care” and I couldn’t agree more. Read more »

Third Circuit Court of Appeals Says Conestoga Wood Specialties Must Comply with Contraceptive Coverage Benefit

Conestoga Wood Specialties is one of the almost 30 plus companies challenging the contraceptive coverage benefit. Conestoga has been arguing that, as a secular, for-profit corporation, it can exercise religious beliefs and that it should be allowed to impose those religious beliefs and the beliefs of its owners on its employees. Today, the 3rd Circuit Court of Appeals said, quite simply, “no way!”  

The court’s decision makes three important points: (1) Conestoga, as a for-profit, secular corporation, cannot exercise religious beliefs; (2) the Hahns, Conestoga’s owners, cannot impose their religious beliefs on their employees through their company; and (3) the decision does not disrespect the Hahns’ religious objections to contraception. Read more »

Getting the Breast Pump She Deserves: My Sister’s Story

When my sister Leah found out she was pregnant with her second child, she knew that she wanted to breast feed the new baby for a year. She planned to go back to work when her daughter was only 4 months old, so she needed a breast pump. In December of 2012, she called her insurance company to find out what kind of coverage the company would provide. During that first call, Leah was given the run around. Everyone she spoke to told her it was not their responsibility to cover her breast pump, she should call someone else. After several useless calls, Leah gave up.

Six months later I started an internship at the National Women’s Law Center. I learned that the health care law requires insurance companies to provide coverage of breast pumps for women without co-pays or deductibles. However, my sister, like many women, still didn’t know about this part of the law, so I decided to give her a call. We talked through her situation and I directed her to some NWLC resources, including the NLWC toolkit, that could help her get the coverage she deserves. Read more »

Hanging with Mr. President

At the White HouseSo yesterday was a REALLY exciting day for me! I was invited to the White House to see President Obama give a speech on the health care law, a.k.a. Obamacare. There are a lot of beneficial parts of the health care law for young women such as myself, like no co-pay preventive services and no longer being charged more for insurance by simply being a woman. I was asked to come to the White House because a few months ago I received a rebate from my insurance company. Yes, my insurance company sent me a check as opposed to a bill. The reason for this is that there is a provision in Obamacare that says that insurance companies have to use 80% of premium costs on care. If insurance companies do not use the majority of funds on care then they need to return the difference. Pretty great, right?

How it worked for me was that because I have insurance through NWLC, they received the check and the amount that normally comes out of my paycheck for my insurance plan was less. Some people might not even realize that they received the rebate but I was watching for it. Full disclosure, I have a lot of student loans, but on one of my loans I was really close to paying it off. When I received that extra amount in my paycheck, I was actually able to pay off one of my student loans!! Read more »

Calling All Moms: Enrollment in the ACA’s Health Care Exchanges Starts October 1

I have two older brothers, ages 28 and 33. We don’t agree on most things and a bickering dinner table is common place—until our mom steps in.

On March 23, 2010 President Obama signed the Patient Protection and Affordable Care Act—dubbed “Obamacare”—into law. That’s right: it’s the law. Over the past three years, parents have been able to keep children under 26 insured through their plans, those with a pre-existing condition have been able to get covered, and seniors have stopped skipping their prescription medication. And this October 1, enrollment for the individual marketplace exchanges will open.

“I’m curious, what would make you sign up for Obamacare?”

“I’m not going to; I don’t believe in Obamacare.”

Not the best way to phrase the question for my brother, I admit. The fact is, enrollment is beginning soon, and I’m tired of talking politics when it comes to health care. After 37 House of Representatives votes, the ACA is still moving forward. The law has sustained several challenges in court and has helped to better cover many people in this country. What I wanted to say to my brother was, “Let’s move on, because it’s the law. And it can help you.” Read more »

Why Today’s House Vote Could Mean Higher Insurance Premiums

Today, the U.S. House of Representatives is voting to delay the Affordable Care Act’s individual responsibility provision. Coincidentally, this is happening on the same day that the New York Times is reporting that New York’s insurance rates for 2014 are AT LEAST 50% lower than current rates. An individual living in New York City who currently pays $1000 a month for health insurance will see their rate decrease to just $308 a month. And that’s even BEFORE factoring in new federal subsidies that will help individuals cover a portion of their premium costs.

It’s pretty obvious that lower rates are good news for all New Yorkers, particularly women who have a harder time affording health care and are more likely than men to avoid needed health care services because of cost, but this news should also convince the House to vote down the effort to delay the individual responsibility provision. Read more »

Seven Reasons Why the Senate’s Labor-HHS-Education Funding Bill Has Us Cheering

The Senate Subcommittee on Appropriations for Labor, Health and Human Services, and Education and Related Agencies just approved a funding plan for those agencies in Fiscal Year 2014. The full Committee will consider the bill tomorrow.

During the Subcommittee’s consideration of the bill, Senators voiced their appreciation of the bipartisan effort and conversations leading up to the bill. Senator Barbara Mikulski (D-MD), Chair of the Subcommittee, expressed her commitment to get the bill on the Senate floor saying “If we move this bill, America and the people who live in it will be in a better place.”  Senator Mikulski explained that the appropriations bill laid the groundwork for expanding opportunity in America through empowering students, investing in education and getting people to work in the 21st century.

We agree. The bill not only rejects the painful cuts from sequestration—it provides additional funding in several key areas, especially early childhood education. Here are seven reasons we were dancing in our offices when we saw the details of the Senate Subcommittee’s FY 2014 Labor, Health and Human Services Education and Related Agencies appropriations bill:

  1. Early Childhood Education: A $1.43 billion increase for Head Start, including Early Head Start - Child Care Partnerships, plus a $171 million increase for existing Head Start and Early Head Start programs; a $176 million increase for the Child Care and Development Block Grants, including $110 million for new quality improvement grants and $66 million for child care assistance as well as $750 million for Preschool Development Grants.
  2. Implementing the Affordable Care Act (ACA): $5.2 billion to the Centers for Medicare and Medicare Services to implement the Affordable Care Act, an increase from $3.9 billion in FY 2013.  The ACA will help nearly 30 million Americans, including nearly 15 million women, to access high-quality, affordable health insurance.
  3. Mental Health: $40 million for Project AWARE State grants, which will focus on making schools safer and connecting young people with mental health services, and $40 million in new funding to address shortages in the behavioral health workforce.

What Delaying the Health Care Law's Employer Responsibility Requirement Means for Real People

Yesterday's surprise announcement that the Obama Administration is postponing implementation of the health reform law's requirement that firms with more than 50 workers provide affordable, comprehensive health insurance or pay a small penalty set off a flurry of commentary and speculation. Much of this reaction focused on how the decision will affect larger employers and their workers — that is, very little — and others weighed in on the political implications of this move. The biggest impact on large employers is if they do not provide the requisite health insurance they will not have to pay the penalty for one more year. But little analysis and commentary considered what this decision means for low-wage workers' access to health insurance exchanges, nor the outreach and education challenges it creates. 

With or without this postponement, beginning January 1, many workers whose employers do not offer coverage, or whose employer offers coverage that does not meet minimum standards for premium affordability and sufficient benefits, will qualify for help with premiums and cost-sharing for coverage they purchase in the health insurance exchange operating in their state. These marketplaces will offer participants a choice among fully-vetted health plans that meet state and federal standards. Workers with good employer-sponsored health insurance won't be able to receive subsidies to purchase coverage in the exchange, but those workers without access to good employer-sponsored coverage, or coverage that exceeds 9.5 percent of their incomes, will qualify for this help. 

Today, low-wage workers are more likely to pay a larger share of the premium for employer-sponsored coverage than workers with higher earnings.  Read more »

One Year Later: SCOTUS, the Affordable Care Act, and Unfinished Business

Today marks the one-year anniversary of the Supreme Court's historic ruling that upheld the constitutionality of the Affordable Care Act (ACA). In National Federation of Independent Business v. Sebelius,  the Court upheld the constitutionality of two major provisions of the ACA: the individual mandate and the Medicaid eligibility expansion. However, the Court made one very significant change to the terms of the Medicaid provision: It held that the federal government could not condition a state's current federal Medicaid funding on participation in the coverage expansion, thereby giving states the choice to opt-out of covering more people through Medicaid. 

Today, Medicaid programs in all states cover low-income individuals with disabilities, seniors, children, pregnant women, and parents. But federal money provided through the ACA will enable states to reach people younger than 65 whose income is below 138 percent of the federal poverty guideline ($15,856 annually for an individual; $26, 951 for a family of three in 2012). 

For the first time, low-income childless adults will have access to Medicaid coverage in many states. 

If all states take this federal money, approximately 15.1 million currently uninsured adults [PDF] would newly qualify for Medicaid coverage. Covering more people through the Medicaid program is especially important for low-income women who make up over 60 percent of uninsured women in the U.S. and are four times more likely than higher income women to report fair or poor health.  Read more »