AAPD Staff has been attending briefings, collaborating with partners, and diligently researching the impact that the recently passed health reform laws, like The Patient Protection and Affordable Care Act (HR 3590, Public Law 111-148, signed into law 3/23/10) and the Health Care and Education Reconciliation Act (HR 4872, Public Law 111-152, signed into law 3/30/10), will have on our community. Find below resources, summaries and explanations--our effort to make sure you know how this will affect your life.
Table of Contents
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Overview
Healthcare.gov (The new health care website created by the Department of Health and Human Services):
This easy-to-use website is intended to empower the public by providing a wealth of information about health reform. The site contains a customized insurance options finder with over 3 billion possible combinations, tips for prevention, and information about the Affordable Care Act, including an interactive implementation timeline. The entire site will be in Spanish by the end of July, and it contains various accessibility options at the bottom of the page.
NOTE: Healthcare.gov includes a section specifically for people with disabilities. It specifies the important things the disability community should know as health reform begins to set in. Additionally, it explains what to expect in the future for patients who are losing their insurance, are Medicaid or Medicare beneficiaries, or who need regular or long-term care insurance.
This is a comprehensively detailed explanation on the important provisions that will affect people with disabilities in the Patient Protection and Affordable Care Act. The purpose of this summary is to reiterate that the passage of the law was only the beginning of health reform. The disability community must stay involved and present as implementing regulations are drafted, proposed, promulgated, and implemented.
This is an outline of how the Patient Protection and Affordable Care Act will affect Americans with disabilities by providing greater choices for people with disabilities, including eliminating heath insurance discrimination, lowering costs by rewarding quality and cutting waste, and assuring accessible, high-quality, affordable health care for people with disabilities.
Useful Resources on Health Care Reform
From Disability Coalition on Health Care Reform (1.27.10):
What Health Reform Means for People with Disabilities
From Families USA (4.7.10) :
What Will the New Health Reform Law Do in the First Year?
Understanding the New Health Reform Law--Early Medicaid Expansions under Health Reform.
From AARP (5.1.10):
User's Guide to Health Care Reform
From The Nebraska Advocacy Services:
Health Care Reform for Persons with Disabilities: Key Principles and Recommendations
From Healthcare.gov (The Department of Health and Human Services):
The Implementation Center of Healthcare.gov is meant to educate the public about implementation and rulemaking around health reform. Because so many of the provisions spelled out in the Affordable Care Act are left to HHS and CMS for implementation, health reform policymaking has only just begun. In the Implementation Center, the public can follow the rulemaking process (under Regulations), learn about the new responsibilities of HHS (under Authorities), read federal correspondence related to health reform implementation (under Letters), discover grant opportunities (under Grants), and find public education materials (under Brochures).
>>>For more information
From The American Academy of Homecare Physicians (AAHCP):
This is a summary of the Independence at Home (IAH) provision of the Affordable Care Act. IAH establishes programs that provide "home-based primary care" to those who have difficulty leaving home to visit doctors, particularly seniors. It aims to save money for hospitals and Medicare by reducing emergency room visits and providing consistent care.
>>>For more information
From Families USA:
This page summarizes the new Medicaid Community First Choice option included in the Affordable Care Act. The CFC option attempts to neutralize the insitutional bias in Medicaid by allowing Medicaid beneficiaries to access necessary services at home and in the community.
>>>For more information
From the Changes In Healthcare Financing and Organization (2.10):
This is a summary of the Community Living Assistance Services and Supports (CLASS) Act, a program designed to provide long term care insurance to people with disabilities or chronic conditions that need assistance with daily activities. The CLASS Act requires that beneficiaries work and pay into the fund for at least five years before receiving benefits.
>>>For more information
From Families USA (7.10):
Helping People with Medicare
Straight Talk for Seniors on Health Reform
Powerpoint: Medicare, Health Reform, and You
Issue Brief: Moving toward Health Equity: Health Reform Creates a Foundation for Eliminating Disparities
Powerpoint: Health Reform: Laying the Foundation for Equity
News Reports
President Obama signs the Patient Protection and Affordable Care Act (3.23.10) (Photo from Speaker Pelosi on Flickr)
From The New York Times:
This article by David M. Herszenhorn asks the question that many of us are thinking: "What will this health care reform law do for me?" This article helps explains health care reform through the story of Natoma Canfield, describing how under new laws she will be able to get some help in her treatment for Leukimia. The article points out the lives of those that gave support to the law like Natoma Canfield of Medina, Ohio. Her story is one about not been able to afford her insurance which not only helped the President Obama present his point of the need of a health care reform to a group of insurance executives but also change the mind of some members of Congress who refuse this Health Reform at first. Under new laws Natoma Canfield, would not need to only to rely on her disability but also on her earning below the federal poverty limit to qualify for Medicaid just like so many others.
This article by Robert Pear discusses the temporary high-risk insurance pools run by the federal or state governments. These pools will be open to people who have been denied insurance based on preexisting conditions for at least 6 months. Beginning on or before July 1, state governments were required to establish these pools or allow the federal government to take control. These pools will be crucial for many people with disabilities and chronic conditions.
From Kaiser Health News:
The article by Harris Mayer talks about the Community Living Assistance Services and Supports (CLASS) Act, and how it will give families greater means to care for disabled relatives.
This article by Mary Agnes Carey and Andrew Villegas covers health reform provisions that have been less publicized, including free preventive services, the focus on comparative effectiveness research, a program to provide coverage for early retirees, and other pieces of the law. Some of these provisions, such as care coordination and the expansion of Medicaid, are particularly relevant to people with disabilities.
From The Los Angeles Times:
This article by Noam N. Levey outlines the individual patient protection measures included in the original Affordable Care Act. According to the law these regulations would not apply until 2014, but to provide protection until that time President Obama proposed that the government institute a patient bill of rights. As more frequent, but often underserved, consumers of health care, people with disabilities will benefit from these protections.
From The New England Journal of Medicine:
This article by Henry J. Aaron, Ph.D. and Robert D. Reischauer, Ph.D., written just after the passage of the Affordable Care Act, discusses the continuing controversy over health reform. Aaron and Reischauer predict conservative backlash as well as a range of obstacles to implementation. They recommend that reform supporters prepare themselves for the battle that is to come.
This article by Gordon D. Schiff, M.D. and David W. Bates, M.D. addresses the emerging use of Health Information Technology (HIT) in clinical care. Schiff and Bates argue that the efficiency and reliability of Electronic Health Records (EHRs) will reduce the frequency of diagnostic errors among healthcare providers. A possible concern for physicians and patients with disabilities is the accessibility of this technology, particularly for those with visual or hearing disabilities.
From the U.S. News and World Report:
Young adults with disabilities often have difficulty getting insurance that is affordable and addresses their needs. This guide to the insurance market, written by Megan Johnson, provides eight options for young adults. The Affordable Care Act will allow young adults to stay on their parents' health plans until age 26; this article examines the pros and cons of this and other options.
Implementation Timelines
From Health and Human Services (6.30.10):
An interactive timeline explaining implementation of the Affordable Care Act from 2010 to 2015.
>>>For more information
From The Kaiser Family Foundation (3.1.10):
Focus on Health Reform: Health Reform Implementation Timeline (2010-2018)
>>>For more information
From The Commonwealth Fund (4.1.10):
This timeline for health care reform implementation provides the health insurance provisions of both the the Affordable Care Act (ACA) and the Health Care & Education Reconciliation Act (HCERA) by year from 2010 to 2018.
>>>For more information
From Families USA (4.7.10):
Health Reform Implementation: The First 90 Days A State Advocate’s To-Do List.
>>>For more information
From AAPD: JFA Blog (3.31.10):
Health Reform Implementation: When, How and For Whom will This Make Change.
>>>For more information
Briefing Summaries
The Patient Protection and Affordable Care Act (4.19.10):
The Patient Protection and Affordable Care Act or PPACA is a package of health care law changes combined into an extensive health reform law. This package will ensure that, “…Americans have access to quality, affordable health care and significantly reduce long-term health care costs.” The goal of this package is to provide coverage to 32 million Americans while making a long term goal to lower the cost of the coverage to make it more affordable. This package includes health-related tax increases and provisions like increasing Medicaid eligibility, supporting medical research, and other. The act also creates penalities for those who choose not to purchase insurance and for employers who do not provide sufficient coverage. PPACA is serving the disability community by providing programs like the Community Living Assistance Services and Supports (CLASS) Act, a self-funded long term care insurance program paid for by optional payroll deductions that allows beneficiaries to receive care at home or in the community, and a Community First Choice Option linked to Medicaid.
>>>For more information
Health Care and Education Affordability Reconciliation Act (4.19.10):
The Health Care and Education Affordability Reconciliation Act, aims to ensure that all Americans have access to quality, affordable health insurance; its goals are similar to those of PPACA (Patient Protection and Affordable Care Act). This Act will ensure that 95 percent of all Americans will have access to affordable health insurance. Furthermore, it will reduce our deficit by $143 million over the next ten years. The Health Care and Education Reconciliation Act is divided into two titles, one addressing health care reform and the other addressing student loan reform. The part addressing health care reform will limit the cost of premiums and provide cost sharing for individuals under 400 percent of poverty like families of four or more but with income less than $88,000; it will also “establish new requirements for community mental health centers to prevent fraud and abuse.” The student loan reform title with the HELP committee provisions will include $36 billion over ten years to increase the maximum Pell Grant to $5,550 in 2010 and to $5,975 by 2017.
>>>For more information
The Reality of Health Care Implementation (7.9.10):
These Powerpoints were presented at a briefing hosted by the Alliance for Health Reform and the Robert Wood Johnson Foundation called "Health Reform Implementation: When Sausage Making Moves Downtown." The briefing covered the process and challenges of formally implementing health reform.
"Implementing PPACA" by Gail R. Wilensky (Project HOPE)
"Health Reform Implementation" by Katherine Hayes (The George Washington University, Department of Health Policy)
"Health Reform Implementation: When Sausage Making Moves Downtown" by Linda E. Fishman (American Hospital Association)
Moving Forward On Health Reform (6.8.10):
This briefing by Health Affairs addressed the future of health reform after the passage of the Patient Protection and Affordable Care Act, particularly from an economic perspective. The Powerpoint below contains the twelve different presentations from the briefing, including remarks from David M. Cutler, Michael Ramlet, Douglas Holtz-Eakin, Bruce H. Harmony, Rich Umbdenstock, Scott Keefer, Len M. Nichols, Ph.D., John Kingsdale, Deborah Chollet, Leighton Ku, Alan Weil, Raymond C. Scheppach, and Thomas P. Miller.
Health Affairs: "Moving Forward On Health Reform"
What Does Health Reform Mean for Long Term Services and Supports? (6.30.10):
This Powerpoint, presented as part of a Webinar by the Center for Personal Assistant Services, addresses the provisions in the Affordable Care Act that will impact long term services and supports, including dependable coverage, the CLASS Act, Medicaid home and community based services, chronic care, and nursing home reforms.
>>>To download the Powerpoint
What is PhRMA Saying about Health Care Reform? (4.28.10):
These Powerpoints were presented in a meeting called, "Health Care: What Does That Mean for You?" where Pharmaceutical Research and Manufacturers of America (PhRMA) explained their view on Health Care Reform and how it will impact many communities like ours.
The Patient Protection & Affordable Care Act of 2010: What it Means for Consumers
"Some Thoughts About Medicaid Post HCR" by Donna A. Boswell.
50 Ways to Implement Health Reform: State Challenges and Federal Assistance (8.2.10)
This briefing was presented by the Alliance for Health Reform and addressed collaboration between federal and state governments to implement health reform. Speakers included Jay Angoff, Len Nichols, Brian Webb, and Lorenz Meinhold, and the brief was moderated by Senator Jay Rockefeller and Ed Howard. The link below contains a full webcast of the briefing and a variety of offsite materials.
50 Ways to Implement Health Reform: State Challenges and Federal Assistance
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