The House Health Care Plan: Bad Medicine for Children and Families

By Janet Murguía, President and CEO, NCLR

Some simple ways to evaluate the new congressional health care plan: when children are covered, they are healthier and do better in school. If they stay healthy, they will have more opportunities as adults. When families are covered, they are better protected from crippling medical debt and homelessness. When more people are covered, our country’s productivity and economic well-being are secured.

The “American Health Care Act” that House congressional leaders proposed last week will drop millions of children and working families from their Medicaid programs. It dismantles health care as we know it, trading in coverage of our nation’s most vulnerable populations for a financial windfall benefiting the wealthy few. And in an analysis released just this week, the Congressional Budget Office gave us our clearest picture yet of the harm the GOP proposal would inflict. The CBO estimates that 14 million people would lose coverage by 2018, 24 million by 2026, and federal Medicaid spending would be reduced by $880 billion over the next 10 years. In short, the historic coverage gains we’ve made over the past few years would be wiped away.

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It’s Time to Get Covered!

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The Affordable Care Act (ACA) has made it possible for 20 million more Americans, including more than four million Latinos, to get health coverage since it was implemented in 2013.

Open enrollment under the ACA is finally here! It is important for you and your family to sign up for health insurance during this open enrollment period, which begins Tuesday, November 1 and runs through January 31, 2017. You can enroll in coverage by calling (800) 318-2596 or by visiting healthcare.gov or cuidadodesalud.gov.

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Hispanic Unity of Florida helps Latinos from Coverage to Care

The NCLR Affiliate educates our community on obtaining and using health insurance

What is the main concern Hispanic Unity of Florida hears from your community members regarding the Affordable Care Act?

Hispanic Unity counselors and navigators have heard a variety of concerns regarding the Affordable Care Act. Most of the time, the concern is about the tax penalty for not having health insurance. Consumers know that if they do not enroll for coverage they may have to pay a fee when they file their taxes. The per-person charge in 2016 will jump to $695 per adult and $347.50 per child, topping out at $2,085 per family. The income-based penalty rises to 2.5 percent of the annual income.

Another concern we have heard in the community regarding the Affordable Care Act is the lack of knowledge of the health insurance system. Most people have difficulty understanding complex terms like deductible, coinsurance, or tax credits. It is fairly understandable because this program is new for almost everybody. But, thanks to our trained navigators and certified application counselors, we can help clarify these terms to make them more understandable to our clients.

Lastly, a concern particularly true in Florida is the lack of eligibility due to low income. We hear from consumers who earn less than 100 percent of the federal poverty level that they do not understand how it is that they do not qualify for tax credits if their income is low.

How do navigators and others in your organization talk to people in your community about the value of health insurance, even for those who consider themselves healthy?

We emphasize that there are many options available no matter what their health situation is. There are plans for the healthier population while there are also plans for those who use health care services more often.

The best thing about this program is that it is not allowed to refuse coverage to anyone based on pre-existing conditions. Sick or not, these plans can work for anybody.

We also like to remind them that these plans can help people save money on out-of-pocket costs in case of a dire emergency. Our navigators inform consumers about the importance of health insurance by explaining different scenarios that could happen unexpectedly, such as getting sick or getting into an accident. We also explain the difference in costs between having insurance and not having insurance when going to the emergency room. It is important to make them understand that prevention is key. The same way they cover their cars and their homes in case of an accident and or a natural disaster, they must make their health coverage a priority. We help them understand that staying healthy to enjoy their other assets makes more sense.

Is cost a concern? Do people understand that they most likely qualify for financial assistance to enroll in a health plan? How do you help them with this concern?

Yes, premium cost is a top concern for health insurance shoppers. We help consumers understand that financial assistance is available for those who qualify. We make sure they understand that the amount of financial assistance they receive depends on income, household size, and many other factors. When we help consumers apply for coverage in the Health Insurance Marketplace, we help them find out whether they qualify for a “premium tax credit” that lowers the premium, which is the monthly amount they will have to pay to their insurance carrier.

However, we know that not everybody will qualify and some might fall into what is called the “coverage gap.” This is one of the most disconcerting barriers some of our clients ultimately face.

Are you still seeing most people come in to get covered for the first time, or are more coming in for help to re-enroll?

There is a mix of those who want to enroll for the first time and people who want to renew their current plan. There are also others who had one plan but want to switch to another plan for a variety of reasons. Also, there are people who enroll for the first time because they had a situation change such as increased income or a change in their family configuration. Most people do come to re-enroll in the program. We would say it is about 60 percent of people are re-enrolling, while 40 percent are enrolling for the first time.

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The current open enrollment period ends on January 31. Find out how you can get covered!

Does Hispanic Unity of Florida offer assistance to people on how to utilize their ACA insurance once they have it?

Hispanic Unity of Florida understands people may be overwhelmed by their choices in the Marketplace. After our counselors have helped clients choose a plan that meets their specific family needs, we also help understand how to use their coverage to get the care they need. Hispanic Unity of Florida offers all sorts of assistance regarding health plans. We have knowledge of how to use the insurance plans, how to look for doctors and prescription drugs that are covered in their plan, and other inquiries about their designated health insurance company.

After their application, we help consumers understand key terms, such as copayments, deductibles, and out-of-pocket limits. Consumers always leave better informed about the Marketplace and the insurance company they applied with. If consumers have any concerns or questions regarding their health coverage, they know that they can come back to see an assister to help them get the coverage that is right for them and help them move from coverage to care.

Florida still has one of the highest rates of uninsured children in the United States. Are you seeing more community members coming in to get their children covered? Do parents understand that even if they do not qualify, they can still enroll their citizen children in coverage?

We always explain the importance of having all the family covered. No one should be left behind. We make sure our participants understand that even when they are not qualified for coverage, we can submit the application and let the Marketplace send the information to Florida KidCare (CHIP) or Medicaid to confirm their eligibility and help them.

We also explain that when it comes to enrolling children in health plans, once an application is submitted, the Health Insurance Marketplace will send their information to a designated health company (Medicaid or CHIP) so they can make a final determination. We also explain to our clients that children who do not qualify for either Medicaid or CHIP can enroll in a plan with their parents until the age of 26.

Find out more about Hispanic Unity of Florida on Facebook and Twitter.

Weekly Washington Outlook — October 26, 2015

U.S. Capitol

What to Watch This Week:

Congress:

House:

On Monday, the House will consider H.R. 3033 – Research Excellence and Advancements for Dyslexia (READ) Act, as amended (Sponsored by Rep. Lamar Smith / Science, Space, and Technology Committee) under suspension of the rules.  While not on the Majority Leader’s schedule, the House is also expected to bring up a discharge petition to reauthorize the Export-Import Bank.

On Tuesday and Wednesday, the House will vote on the following:

  • Concur in the Senate Amendment to R. 623 – DHS Social Media Improvement Act of 2015 (Sponsored by Rep. Susan Brooks / Transportation and Infrastructure Committee)
  • R. 3819 – Surface Transportation Extension Act of 2015 (Sponsored by Rep. Bill Shuster / Transportation and Infrastructure Committee)
  • R. 455 – Northern Border Security Review Act, as amended (Sponsored by Rep. John Katko / Homeland Security Committee)
  • R. 1317 – To amend the Commodity Exchange Act and the Securities Exchange Act of 1934 to specify how clearing requirements apply to certain affiliate transactions, and for other purposes (Sponsored by Rep. Gwen Moore / Financial Services Committee)
  • R. 3032 – Securities and Exchange Commission Reporting Modernization Act of 2015 (Sponsored by Rep. Kyrsten Sinema / Financial Services Committee)
  • 2036 – Equity in Government Compensation Act of 2015 (Sponsored by Sen. David Vitter / Financial Services Committee)
  • R. 2643– State Licensing Efficiency Act of 2015 (Sponsored by Rep. Roger Williams / Financial Services Committee)

This week, the House will also consider H.R. 1090 – Retail Investor Protection Act, Rules Committee Print (Subject to a Rule (Sponsored by Rep. Ann Wagner / Financial Services Committee).  Legislation related to the debt limit is also possible.

Finally, on Thursday, the House will elect a new Speaker.

Senate:

This week, the Senate will resume consideration of S. 754, a cybersecurity bill.

White House:

On Monday, the President will attend Senator Daschle and Senator Mitchell’s Luncheon at the Metropolitan Club in Washington, DC. In the afternoon, the President will welcome President Joko Widodo of Indonesia to the White House. As leaders of two of the largest democracies in the world, the President and President Widodo will discuss plans to expand existing areas of bilateral cooperation, including in defense, trade and investment, climate and energy, as well ways to pursue new growth areas for the partnership, such as maritime cooperation.

On Tuesday, the President will welcome the United States Women’s National Soccer Team to the White House to honor the team and their victory in the 2015 FIFA Women’s World Cup. In the afternoon, the President will travel to Chicago, Illinois to address the International Association of Chiefs of Police at the 122nd Annual IACP Conference and Exposition. The event is the largest gathering of law enforcement leaders in the world with more than 14,000 public safety professionals and 700 exhibiting companies. Later in the day, the President will attend a DSCC event and a DNC event. The President will remain in Chicago overnight and return to Washington, D.C. on Wednesday.

On Thursday, the President will participate in a DCCC roundtable.

On Friday, the President and the First Lady will welcome local children and children of military families to trick-or-treat at the South Portico of the White House.

Also This Week:

Immigration – This week, the House will vote on H.R. 455, legislation requiring the Department of Homeland Security to conduct a threat analysis of the U.S.-Canada border.

Debt Limit – The Department of the Treasury estimates the United States will reach the debt limit on November 3rd.  It is possible the House may act to raise this as soon as this week, although details are not clear.

Financial Services – The House will vote on legislation this week (S. 2036) that would suspend pay increases for the CEOs of Fannie Mae and Freddie Mac.  The bill requires the Federal Housing Finance Agency to limit compensation to the CEOs to $600,000.  Elsewhere, the House will also vote on legislation (H.R. 1090) that would block the Department of Labor’s proposed “conflict of interest” rule for brokers handling retirement accounts.

Judiciary – Attorney General Loretta Lynch will testify Wednesday before the House Judiciary Committee at an oversight hearing.

Education – While conferees have not yet been formally appointed to the ESEA conference committee, staff-level work continues to reconcile the Senate’s Every Child Achieves Act with the House’s Student Success Act.  There are significant differences between the two bills; notably, neither has strong accountability language ensuring intervention if students are not meeting academic goals.  Conferees are likely to be named at some point in the coming weeks.

Healthcare – Last week, the House passed reconciliation legislation that would repeal the ACA’s employer and individual mandates and defund Planned Parenthood, among other provisions.  This week, the legislation is facing some opposition from conservative members of the Senate arguing that it does not go far enough.  Timing of Senate consideration, as a result, is not clear.

Republican Leadership Election – On Wednesday, the House Republican Conference will meet to elect Congressman Paul Ryan as Speaker of the House.  A full House vote will occur on Thursday.  Congressman Ryan’s election to Speaker will create a vacancy at the top of the Ways and Means Committee, likely to be filled by either Rep. Kevin Brady (R-TX) or Rep. Pat Tiberi (R-OH).