Health Reform Hub

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Announcement of Funding Opportunity for Cooperative Agreement: The Affordable Care Act and What it Means for People with Disabilities

The National Council on Disability has announced this funding opportunity for a research project regarding the Affordable Care Act and its impact on people with disabilities.



Obamacare: The Metrics in the News are Mostly Wrong

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In this post, Kaiser Family Foundation President Drew Altman explains why judging the success of the Affordable Care Act by total enrollment figures or young adult enrollment is "the equivalent of judging the local weather from national averages."



Get Covered Plan Picker

Get Covered America created this easy tool to help consumers understand what the different mental levels mean and which might be right for them.



Assessing Care Integration for Dual-Eligible Beneficiaries: A Review of Quality Measures Chosen by States in the Financial Alignment Initiative

The Affordable Care Act included a demonstration program to test ways to align financing and integrate care for people who are eligible for both Medicare and Medicaid. This brief from the Commonwealth Fund reviews the quality measures chosen by eight demonstration states. The authors find that while some quality domains are well represented, others are not. Quality-of-life measures are notably lacking, as are informative, standardized measures of long-term services and supports.



Seizing the Opportunity: Early Medicaid Health Home Lessons

Medicaid health homes, made possible through the Affordable Care Act, provide states with a mechanism to support better care management for people with complex health needs with the goal of improving health outcomes and curbing costs. As of March 2014, 15 states have 22 approved state plan amendments to implement Medicaid health homes. Six "early adopter" states - Iowa, Missouri, New York, North Carolina, Oregon, and Rhode Island - have collectively enrolled more than 875,000 Medicaid beneficiaries in health homes. This brief draws from the experiences of early health home adopter states to outline elements critical to implementation and sustainability of this new model. The brief informs other states looking to develop effective health home programs.



Details Matter! Advocates Library of Managed Long-Term Services and Supports Contract Provisions

A wave of Medicaid Managed Long Term Services (MLTSS) is currently sweeping the country and promising to impact the way care is delivered to millions of seniors and people with disabilities. Whether this impact is ultimately positive or negative will depend on the details of how these new systems are designed, implemented and held accountable. This new resource can help advocates ensure that states and plans get the details right.



Proposed Rule: Exchange and Insurance Market Standards for 2015 and Beyond

Proposed Navigator and Marketplace Standards

This proposed rule from the Centers for Medicare and Medicaid Services (CMS) includes standards for Health Insurance Marketplaces as well as protections and standards for Navigators and other consumer assistance personnel.



Comparison of Medicare Advantage, Qualified Health Plans, and Medicaid Managed Care Organizations

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This issue brief examines the similarities and differences in consumer protections in three major sources of insurance coverage delivered through private plans: Medicare Advantage (MA), Qualified Health Plans (QHPs) offered through the Marketplaces, and Medicaid Managed Care Organizations (MCOs). These three insurance markets, to different extents, are overseen by the same agency within the federal government, the Centers for Medicare and Medicaid Services (CMS).



Visualizing Health Policy: What Americans Pay for Health Insurance Under the ACA

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The March 2014 Visualizing Health Policy infographic shows examples of what Americans will pay for health insurance under the Affordable Care Act, using different scenarios for 40-year-old individuals living in different parts of the country.



Proposed Standards for Navigators and Consumer Assistance Counselors: Preemption of Certain State Navigator Regulatory Laws

A brief from Health Reform GPS

Many states have created policies regulating the activities of navigators created by the Affordable Care Act. On March 17, 2014, HHS released a proposed rule in public view form that addresses a variety of issues including Exchanges, Navigators and Non-Navigator consumer assistance personnel. This brief explains and provides context for the proposed rule.



Marketplace Comparison Worksheet

Form the Center on Budget and Policy Priorities

This worksheet, from the Center on Budget and Policy Priorities' Beyond the Basics project, can help consumers compare Marketplace plans considering costs and their individual needs.



Basic Health Program Final Regulations

A brief from Health Reform GPS

On March 7, 2014, the Centers for Medicare and Medicaid Services (CMS) published final regulations implementing the Affordable Care Act's Basic Health Program (BHP) market option. The BHP is an optional program for states to provide protections for people who may "churn" between Medicaid and the Marketplaces. This brief explains the final regulations from CMS.



Medicaid and Marketplace Eligibility Changes Will Occur Often In All States; Policy Changes Can Ease Impact

Under the Affordable Care Act (ACA), changes in income and family circumstances are likely to produce frequent transitions in eligibility for Medicaid and health insurance Marketplace coverage for low- and middle-income adults. This Health Affairs article provides state-by-state estimates of potential eligibility changes ("churning") if all states expanded Medicaid under health reform, and identifies predictors of rates of churning within states.



Profiles of Medicaid Outreach and Enrollment Strategies: Using Text Messages to Reach and Enroll Uninsured Individuals into Medicaid and CHIP

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The 2014 Affordable Care Act (ACA) health coverage expansions provide millions of uninsured Americans a new coverage option through Medicaid or Health Insurance Marketplaces. However, effective outreach, enrollment, and retention efforts are essential for ensuring that these new coverage opportunities translate into increased coverage. To provide greater insight into the potential role of text messaging as an outreach vehicle, this brief focuses on the use of standard cell phones and smartphones for text messages and internet access and illustrates how one text messaging initiative, Text4baby, a free, personalized maternal child health education text messaging service for pregnant women and new mothers, is helping eligible pregnant women and their families connect to health coverage.



CMS Bulletin on Premium Subsidies and Cost-Sharing Reductions in 2014 Due to Exceptional Circumstances

A brief from Health Reform GPS

The Affordable Care Act (ACA) provides premium tax credits (PTCs) and cost sharing reduction assistance (CSRs) to help individuals defray the cost of enrolling in qualified health plans (QHPs) provided by insurance issuers and purchased through the Health Insurance Marketplace. Technical problems, however, have plagued many state Marketplaces as well as the Federally-facilitated marketplace during the initial 2014 open enrollment period, resulting in a potential for lost enrollment opportunities. This brief from Health Reform GPS explains the allowances CMS will make in eligibility determinations for those who faced technical difficulties applying for coverage.

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