AUCD Information and Action Alert on Health Care Reform
August 24, 2009
Health Care Reform Information and Action Steps
AUCD believes that the goal of health insurance reform should be to assure that all Americans, including people with disabilities and chronic conditions, have access to high quality, comprehensive (including preventative), affordable health care that meets their individual needs and enables them to be healthy, functional, live as independently as possible, and participate in the community.
Who has health insurance? According to the Kaiser Family Foundation's State Health Facts and Centers for Medicare & Medicaid Services:
- 159 million people have employer-based health insurance;
- 14.5 million people have private insurance purchased in the individual market;
- 44 million (mostly over 65) are covered by government-sponsored Medicare;
- 49 million are on Medicaid, a federal/state shared program for elderly, low income and people with disabilities;
- 45.6 million are uninsured, a third of whom work for businesses with less than 100 workers; and
- People with disabilities are disproportionately represented in the last three statistics above.
The Senate Health, Education, Labor and Pensions (HELP) committee completed its mark up of the Affordable Health Choices Act, and the House has finished mark-up in three committees on its version of the legislation (H.R. 3200). Both the Senate and House versions of the Affordable Health Choices Act include many provisions that are important to the AUCD Network. These provisions, some of which are enumerated below, follow the principles set out by the Consortium for Citizens with Disabilities (CCD) and are supported by AUCD. We believe that these bills could provide a positive, dramatic change for people with disabilities in the area of health insurance and long term care.
Non-Discrimination: People with disabilities of all ages and their families must be able to fully participate in the nation's health care system.
The Affordable Health Choices Act in the Senate and House includes major insurance market reforms such as the elimination of discrimination based on health status, a prohibition on pre-existing condition exclusions, guaranteed issue and renewal requirements, elimination of annual and lifetime caps, and mental health and substance abuse parity requirements. The provisions will improve access to quality health care for people with disabilities who are uninsured or under-insured -- including access to insurance for children who age out of their parents insurance and access to health insurance for young adults and others who may lose insurance when unemployed.
Both bills also include provisions, originally proposed in Senator Harkin's Wellness bill, to require accessible medical diagnostic equipment.
The Senate bill would improve data collection on health disparities for individuals with disabilities.
Comprehensiveness: People with disabilities and their families must have access to benefits that provide a comprehensive array of health, rehabilitation, assistive device, and support services across all service categories and sites of service delivery.
AUCD supports requirements that are in both the Senate and House versions of the Affordable Health Choices Act that will provide economic relief for consumers:
1. No charge (or minimal allowable charge) for preventive care.
2. Cap out of pocket expenses (including deductibles, co-pays and medication expenses).
3. No lifetime caps or annual limits on value of insurance benefits for enrollees.
Both bills also expand Medicaid to higher income families, continue EPSDT requirements, and will provide minimum standards for all health care providers.
Continuity: People with disabilities of all ages and their families must have access to health care that responds to their needs throughout their lifetimes, and provides continuity of care that helps treat and prevent chronic conditions.
AUCD strongly supports the current House and Senate bills provision to establish a national voluntary insurance program for purchasing community living services and supports based on the CLASS Act. This will provide individuals who have functional limitations with tools that will allow them to maintain their personal and financial independence (and not have to impoverish themselves to qualify for Medicaid) while continuing to live and contribute in the community. It will also take pressure off of the Medicaid program, which currently pays for most of the country's long term care.
Both bills would provide a trust fund with dedicated funding for prevention and wellness activities which could assist with health promotion and reduction of secondary conditions for individuals with disabilities
Appropriateness: People with disabilities and their families must be assured that comprehensive health, rehabilitation, and long term support services are provided on the basis of individual need, preference, and choice.
Comprehensive services include:
1. access to trained, qualified, and appropriately credentialed health care personnel;
2. designation of physicians who understand disability and function to help plan and coordinate care with the rehabilitation team as an alternative to gatekeeper case managers with no experience with disability; and
3. services that are patient-centered and consumer-directed to the maximum extent possible.
The Senate bill, among other workforce provisions, creates a program to support the development, evaluation, and dissemination of model curricula for cultural competency, prevention, and public health proficiency and aptitude for working with individuals with disabilities training for use in health professions schools and continuing education programs. The Senate bill contains specific language to improve training opportunities for direct support professionals providing long-term services and supports to individuals with disabilities and seniors.
The House bill includes grants to University Centers for Excellence in Developmental Disabilities to help train professionals to provide services to individuals with ASD and other developmental disabilities.
Action Needed:
- Call your Members of Congress toll-free, 1-888-245-0215. You'll be connected to the Capitol Switchboard; ask to speak to your Member's office. When connected, tell them you support health insurance reform.
- Use AUCD Action Center to email your Members of Congress
- Read the bills, summaries, and analyses on AUCD's public policy website for more details.
