4.683 Million Unanswered Questions in Halbig

Appeals will continue, but let’s take the Halbig decision at face value. How much will this decision cost the working poor? The amount varies with income and other variables, but for a 40 year old individual making $30,000 a year, the tax credit was estimated at $1345 (KFF estimate here). Retroactive tax bills under Halbig will be significant and everyone impacted will have trouble paying for health insurance going forward (about 57% of exchange participants were previously uninsured, according to a KFF survey).

How many people will be hurt?

Read more here at “The Incidental Economist” ….

The ACA Has Spurred The Largest Expansion In Health Coverage In America In Half A Century

Yesterday marked the last day of the six-month open enrollment period for people to get insurance coverage through the state and federal marketplaces. Despite technical challenges and staunch ideological opposition, it has already been a huge success with over six million people enrolling. But in the last several days, the interest in signing up and the outreach efforts to those not yet covered has reached new heights.

Take a look at the final surge by the numbers:

  • 9.5 Million: Number Of Uninsured That Now Have Insurance Thanks To The ACA. A new analysis of enrollment data has found that almost ten million people who were previously without health insurance now are covered. The report estimates that two million have enrolled in private coverage on the new marketplaces; about 4.5 million previously uninsured people have gained public coverage through Obamacare’s Medicaid expansion; and about three million previously uninsured young people are now covered on their parents’ insurance plans. The law, as written by the Los Angeles Times, “has spurred the largest expansion in health coverage in America in half a century.”
  • 10 million: Number Of Visits To Heathcare.gov In The Past Week. The Washington Post tallied 8.7 million in the past week through Monday morning, with 2 million visiting this weekend alone. Today, the Department of Health and Human Services tweeted that there had been another 1.2 million visitors just by noon–”record volume.”
  • 125,000: The Number Of Concurrent Users On Healthcare.gov On Monday. An unprecedented level of traffic on the website has led to an unprecedented number of people using the site to sign up for health insurance.
  • 4,000: Number Of Grassroots Events To Help People Enroll In March. For all the money spent over the airwaves, grassroots organizing was a huge component of outreach efforts to get people signed up for coverage. Events took place all over the country, with a focus on reaching the uninsured to make sure they had the information they needed to enroll.
  • 300: Number of Radio Interviews Administration Officials Have Given In The Past Six Weeks. While there have been enormous efforts to use new media to promote the law, good old-fashioned radio has been a go-to source for top White House officials: from Chief-of-Staff Denis McDonough and Senior Adviser Valerie Jarrett to President Obama himself.
  • 49 Percent: Public Support For The ACA. According to a ABC News/Washington Post poll out today, support for the law is at 49 percent, its highest level in months. Back in November, just 40 percent supported and 57 percent opposed the law; today the picture looks much different:

BOTTOM LINE: If there’s any indication that the Affordable Care Act is in high demand, this is it. The law is working, it’s here to stay, and it’s delivering on its promise to provide quality, affordable health coverage that will be there when consumers need it most. Conservatives will continue their repeal-at-all-costs agenda, but the success of these past six months will make it harder because people do not want to go back to the way it was.


This material [the article above] was created by the Center for American Progress Action Fund. It was created for the Progress Report, the daily e-mail publication of the Center for American Progress Action Fund. Click here to subscribe.

By The Numbers: the First Reporting Period of Open Enrollment

By Kathleen Sebelius, Secretary of Health and Human Services

Today we released our most detailed report to date about the results of the first reporting period of open enrollment in the Health Insurance Marketplace. The numbers show that interest in the Health Insurance Marketplace remains strong and the promise of quality, affordable coverage is becoming a reality for hundreds of thousands of Americans.

Marketplace Open Enrollment: 1st Reporting Period: October 1st Through November 2nd 106,185 Americans have enrolled in a plan through the Marketplace. 975,407 Americans have made it through the process and have not yet selected a plan. 502,466 Americans are positioned to have health coverage starting in 2014 through Medicaid/CHIP. 26,876,527 unique visitors to Marketplace websites. 3,158,436 calls to the federal & state call centers. “The promise of quality affordable coverage is increasingly becoming reality for this first wave of applicants to the Health Insurance Marketplaces. There is no doubt the level of interest is strong. We expect enrollment will grow substantially throughout the next five months, mirroring the pattern that Massachusetts experienced. We also expect that the numbers will grow as the website, HealthCare.gov, continues to make steady improvements.” – Secretary Kathleen Sebelius HealthCare.gov.

Between October 1 and November 2, 2013, 106,185 individuals selected plans from the Marketplace and another 975,407 applied and received an eligibility determination, but have not yet selected a plan. An additional 396,261 were determined eligible for Medicaid or the Children’s Health Insurance Program (CHIP).  In total, 502,446 Americans will be positioned to have health coverage starting in 2014.

As we’ve seen in Massachusetts’s efforts to expand coverage, I expect the number of newly insured to grow substantially throughout the open enrollment period. Our efforts to improve HealthCare.gov will be critical to driving new enrollments and meeting consumer demand.

As a further indication of high consumer interest, web traffic and call center volume also continues to be very heavy. During the first reporting period, there have been over 26 million unique visitors to Marketplace websites and over 3.1 million calls to the call centers.

While we know there is still a lot of work to do to make sure every American that wants access to affordable coverage can have it, there are many encouraging takeaways from today’s report.

For the full text of the report, “Health Insurance Marketplace: November Enrollment Report,” please visit:  http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_enrollment.pdf

Nevada has a state supported exchange, meaning we don’t need to use the national website.  We can go to our own exchange website.  If you don’t have employer provided insurance and will need to enroll for insurance, VISIT THE NEVADA HEALTH LINK NOW TO APPLY today.

Daniel’s Story: Finding Affordable Coverage for $70 a Month

By Salim Zymet, Digital Advisor, Department of Health and Human Services

Enrolling just a day after the Health Insurance Marketplace opened, Daniel, a 22 year old from Orlando, Florida, is one of the millions of Americans eligible for affordable health coverage through the Health Insurance Marketplace.

Daniel says he’s “thrilled” to get coverage at the price he got it, and is relieved to be covered:

“I already had health insurance, but I just wanted to see if I could do a little bit better on the marketplace, and I did. I was able to pick a much higher quality plan, and because of my income as a student, I’ll only pay about 70 bucks a month for health insurance.”

To compare plans in your area, weigh your options, and get enrolled for coverage beginning January 1st, apply on HealthCare.gov by December 15th.

There are 4 basic ways consumers can apply for and enroll in Marketplace coverage: 

  1. Online at HealthCare.gov;
  2. Over the phone by calling the 24/7 customer service center (1-800-318-2596, TTY 1-855-889-4325);
  3. Working with a trained person in your local community (Find Local Help); or by
  4. Submitting a paper application through the call center or downloading a copy at marketplace.cms.gov.

How the Health Care Law is Making a Difference for Nevadans

Because of the Affordable Care Act, the 78% of Nevadans who have insurance have more choices and stronger coverage than ever before. And for the 22% of Nevadans who don’t have insurance, or Nevada families and small businesses who buy their coverage but aren’t happy with it, a new day is just around the corner.

Soon, the new online Health Insurance Marketplace will provide families and small businesses who currently don’t have insurance, or are looking for a better deal, a new way to find health coverage that fits their needs and their budgets.

Open enrollment in the Marketplace starts Oct 1, with coverage starting as soon as Jan 1, 2014.  But Nevada families and small business can visit HealthCare.gov right now to find the information they need prepare for open enrollment.

Key Features of the health care law are already providing better options, better value, better health and a stronger Medicare program for the people of Nevada:

Key Features

Coverage

Costs

Care

Better Options

The Health Insurance Marketplace

Beginning Oct 1, the Health Insurance Marketplace will make it easy for Nevadans to compare qualified health plans, get answers to questions, find out if they are eligible for lower costs for private insurance or health programs like Medicaid and the Children’s Health Insurance Program (CHIP), and enroll in health coverage.

By the Numbers: Uninsured Nevadans who are eligible for coverage through the Marketplace. 

  • 473,971 (22%) are uninsured and eligible
  • 347,244 (73%) have a full-time worker in the family
  • 174,840 (37%) are 18-35 years old
  • 218,730 (46%) are White
  • 44,217 (9%) are African American
  • 157,518 (33%) are Latino/Hispanic
  • 33,012 (7%) are Asian American or Pacific Islander
  • 258,036 (54%) are male

438,826 (93%) of Nevada’s uninsured and eligible population may qualify for lower costs on coverage in the Marketplace, including through Medicaid.

Nevada has received $74,754,285 in grants for research, planning, information technology development, and implementation of its Health Insurance Marketplace.

New coverage options for young adults

Under the health care law, if your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 years old. Thanks to this provision, over 3 million young people who would otherwise have been uninsured have gained coverage nationwide, including 33,000 young adults in Nevada.

Ending discrimination for pre-existing conditions  

As many as 1,157,045 non-elderly Nevadans have some type of pre-existing health condition, including 162,452 children.  Today, insurers can no longer deny coverage to children because of a pre-existing condition, like asthma or diabetes, under the health care law. And beginning in 2014, health insurers will no longer be able to charge more or deny coverage to anyone because of a pre-existing condition.  The health care law also established a temporary health insurance program for individuals who were denied health insurance coverage because of a pre-existing condition.  1,373 Nevadans with pre-existing conditions have gained coverage through the Pre-Existing Condition Insurance Plan since the program began.

Better Value

Providing better value for your premium dollar through the 80/20 Rule

Health insurance companies now have to spend at least 80 cents of your premium dollar on health care or improvements to care, or provide you a refund.  This means that 88,491 Nevada residents with private insurance coverage will benefit from $3,977,544 in refunds from insurance companies this year, for an average refund of $75 per family covered by a policy.

Scrutinizing unreasonable premium increases 

In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Nevada has received $4,959,972 under the new law to help fight unreasonable premium increases.

Removing lifetime limits on health benefits 

The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 937,000 people in Nevada, including 329,000 women and 269,000 children, are free from worrying about lifetime limits on coverage. The law also restricts the use of annual limits and bans them completely in 2014.

Better Health

Covering preventive services with no deductible or co-pay

The health care law requires many insurance plans to provide coverage without cost sharing to enrollees for a variety of preventive health services, such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.

In 2011 and 2012, 71 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 615,000 in Nevada. And for policies renewing on or after August 1, 2012, women can now get coverage without cost-sharing of even more preventive services they need.  Approximately 47 million women, including 391,181 in Nevada will now have guaranteed access to additional preventive services without cost-sharing.

Increasing support for community health centers

The health care law increases the funding available to community health centers nationwide. In Nevada, 2 health centers operate 30 sites, providing preventive and primary health care services to 57,987 people.  Health Center grantees in Nevada have received $8,264,743 under the health care law to support ongoing health center operations and to establish new health center sites, expand services, and/or support major capital improvement projects.

Community Health Centers in all 50 states have also received a total of $150 million in federal grants to help enroll uninsured Americans in the Health Insurance Marketplace, including $451,674 awarded to Nevada health centers.   With these funds, Nevada health centers expect to hire 9 additional workers, who will assist 10,600 Nevadans with enrollment into affordable health insurance coverage.

Investing in the primary care workforce

As a result of historic investments through the health care law and the Recovery Act, the numbers of clinicians in the National Health Service Corps are at all-time highs with nearly 10,000 Corps clinicians providing care to more than 10.4 million people who live in rural, urban, and frontier communities.  The National Health Service Corps repays educational loans and provides scholarships to primary care physicians, dentists, nurse practitioners, physician assistants, behavioral health providers, and other primary care providers who practice in areas of the country that have too few health care professionals to serve the people who live there.  As of September 30, 2012, there were 36 Corps clinicians providing primary care services in Nevada, compared to 12 in 2008.

Preventing illness and promoting health

As of March 2012, Nevada had received $7,500,000 in grants from the Prevention and Public Health Fund created by the health care law. This new fund was created to support effective policies in Nevada, its communities, and nationwide so that all Americans can lead longer, more productive lives.

A Stronger Medicare Program

Making prescription drugs affordable for seniors 

In Nevada, people with Medicare saved nearly $41 million on prescription drugs because of the Affordable Care Act.  In 2012 alone, 22,122 individuals in Nevada saved over $14 million, or an average of $611 per beneficiary.  In 2012, people with Medicare in the “donut hole” received a 50 percent discount on covered brand name drugs and 14 percent discount on generic drugs.  And thanks to the health care law, coverage for both brand name and generic drugs will continue to increase over time until the coverage gap is closed.  Nationally, over 6.6 million people with Medicare have saved over $7 billion on drugs since the law’s enactment.

Covering preventive services with no deductible or co-pay

With no deductibles or co-pays, cost is no longer a barrier for seniors and people with disabilities who want to stay healthy by detecting and treating health problems early. In 2012 alone, an estimated 34.1 million people benefited from Medicare’s coverage of preventive services with no cost-sharing.  In Nevada, 166,815 individuals with traditional Medicare used one or more free preventive service in 2012.

Protecting Medicare’s solvency

The health care law extends the life of the Medicare Trust Fund by ten years.  From 2010 to 2012, Medicare spending per beneficiary grew at 1.7 percent annually, substantially more slowly than the per capita rate of growth in the economy.  And the health care law helps stop fraud with tougher screening procedures, stronger penalties, and new technology. Over the last four years, the administration’s fraud enforcement efforts have recovered $14.9 billion from fraudsters.  For every dollar spent on health care-related fraud and abuse activities in the last three years the administration has returned $7.90.

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