Saturday, November 16, 2013

The Coverage Swap

Governor Walker announced on Thursday that he will call a special session of the Legislature to take up two bills, the most noteable is one to continue BadgerCare Plus benefits for parents between 100% and 200% of the Federal Poverty Level until the end of March and extend HIRSP benefits (State HIRSP) as well. How will the state pay for postponing the cuts? With a coverage swap--by not expanding Medicaid for low-income, childless adults.  About 80,000 of Wisconsin's lowest income, childless adults will remain uninsured for an additional 3 months. They could shop the Marketplace, but they would not be able to get subsidies since this is the population that was supposed to get Medicaid. We discuss this more inside this Newsletter!
Also in this issue, President Obama addressed the nation proposing what he calls a "private insurance fix." But what is the consequence of extending some of these plans? In this edition of the Update, we look at the federal Marketplace, the insurance company and state decisions that may be making things worse.
Read about these breaking news items, case tips, HealthWatch coalition activities, recent articles and more in this week’s Update newsletter. Thanks to all of the current members, subscribers, and supporters--you make the HealthWatch Update possible!
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Mental Health Parity Decades in the Making
On November 8, the US Department of Health and Human Services (HHS) together with the Department of Labor and Treasury jointly issued a final rule to implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA). The Act, among other things, ensures that health plan features (like co-pays, deductibles, visit limits) are not more restrictive for mental health and substance abuse disorders than for other medical and surgical benefits. A press release issued by HHS outlines the consumer protections in the final rule:
  • Ensuring that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings
  • Clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law
  • Clarifying that parity applies to all plan standards, including geographic limits, facility-type limits, and network adequacy
  • Eliminating an exception to the existing parity rule that was determined to be confusing, unnecessary, and open to abuse.
The Kaiser Health News released a podcast with conversation about the long-awaited mental health parity law regulations. 

Obamacare y Usted

The Kaiser Family Foundation, known for producing handy tools and resources to explain health reform, has done it again. On the heels of their very successul premium calculator, they have created a new Spanish Language consumer resource center to explain "how the ACA may impact individuals and families throughout the United States." The site features a new Spanish Language subsidy calculator to help consumers estimate premiums and tax credits in the Marketplace. Organizations are invited and encouraged to embed the calculator on their own websites for free. The website also features the "Obamacare and You" factsheet, now in Spanish (Obamacare y Usted.)

Share Your BadgerCare, Medicaid, or Marketplace Story!

Are you one of the more than 90,000 parents who will lose BadgerCare Plus coverage in 2014?
Are you under 100% FPL and moving to BadgerCare?
Are you a mother or father just making ends meet who's concerned about the new changes to BadgerCare coverage?
Are you not sure WHERE TO GO for help?
Tell us your health care and coverage story! As 2013 comes to a close, the health care landscape in Wisconsin is changing. If you or a loved one will be changing insurance, losing BadgerCare Plus or going to the Marketplace to purchase insurance for the first time, we’d like to hear your story! There are many ways to contact us:

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