The Patient Protection and Affordable Care Act will improve the health care of nearly 30 million women in the U.S., according to an issue brief published by The Commonwealth Fund.

By the time the law fully takes effect in 2014, up to 15 million uninsured women will be eligible for subsidized coverage, and an additional 14.5 million insured women will see improved coverage and/or reduced premiums.

Low-income women will especially benefit from the law, the issue brief states.

President Obama signed the Patient Protection and Affordable Care Act this past March as part of his administration’s effort to enact national health reform.

Implications for Direct-Care Workforce

Perhaps the most significant provision of the act will be an expansion of Medicaid eligibility to cover adults earning up to 133 percent of the federal poverty level (currently about $14,400 for a single adult).

An estimated 8.2 million uninsured women between the ages of 18 and 64 will be eligible for Medicaid when that provision takes effect in January 2014, The Commonwealth Fund report found.

A significant number of these millions of uninsured women are members of the direct-care workforce, which is 90 percent female, PHI research (pdf) suggests.

Approximately one out of four direct-care workers is uninsured, and many of them would be eligible for Medicaid under the new eligibility rules. The median annual income of direct-care workers is just $17,000; personal and home care aides make an average of $12,000 a year.

PHI has compiled a chart (pdf) on other health-reform provisions that will affect the direct-care workforce.

More Helpful Provisions

The Commonwealth Fund’s issue brief details several other provisions that will benefit women.

Beginning September 23, 2010

• Health plans will be required to cover a wide variety of services without requiring cost-sharing. Those services include screenings for breast cancer, and cervical cancer, as well as osteoporosis screenings for women age 65 and older.

Beginning January 1, 2014

• Insurance companies will be required to accept every individual who applies for coverage, and will be forbidden from charging higher premiums based on gender or pre-existing medical conditions.
• Health plans sold through state insurance exchanges will be required to cover maternity and newborn care.

– by Matthew Ozga

Americans in need of health insurance have a new online resource to help guide them through their options, courtesy of the Department of Health and Human Services (HHS).

HealthCare.gov, which launched on July 1, allows health care consumers to easily view all of the ways they can obtain insurance.

“For too long, the insurance market has been confusing and hard to navigate,” said HHS secretary Kathleen Sebelius. “HealthCare.gov makes it easy for consumers and small businesses to compare health insurance plans in both the public and the private sector.”

The creation of the website was mandated by the Patient Protection and Affordable Care Act, the wide-ranging health reform legislation President Obama signed in March.

The site also provides links to two other online resources run by HHS: Healthfinder.gov, an inventory of health advice, and Hospital Compare, which allows users to compare the quality of care of hospitals throughout the country.

Customized Information

Users of HealthCare.gov can receive customized information based on their current circumstances.

In addition to having to provide their age and state of residency, users are asked to answer several short questions regarding their health status and the extent to which they are having difficulty paying for insurance.

Once those questions are answered, users are guided to a list of as many as eight possible insurance options, ranging from government programs (such as Medicaid, COBRA, and the Pre-Existing Condition Insurance Plan) to private insurance plans based in their area.

Small businesses can also use the site to find ways to ensure coverage for their employees.

“PHI is working to get the word out to the thousands of uninsured direct-care workers — and their employers — who will benefit from this information,” said PHI government affairs director Carol Regan.

Additional and Upcoming Features

HealthCare.gov also includes a section explaining the new health reform bill, and how it will impact ordinary Americans. It features an interactive timeline showing how and when each new section of the law will be phased in.

Indeed, as health reform continues to be integrated into U.S. law, HealthCare.gov will be updated to reflect those changes.

Starting in October, it will include price estimates for private insurance plans; HHS plans to include performance data on each plan at a later date.

By 2014, when the entire health reform law takes full effect, state-based insurance exchanges will run their own websites allowing consumers to compare insurance plans.

– by Matthew Ozga

A new PHI fact sheet outlines several ways that small businesses can receive government aid to help them take advantage of opportunities in the health reform law that passed earlier this year.

Health Reform Facts 3 is the latest in a series of PHI publications that describes how health reform provisions affect eldercare/disability employers and direct-care workers.

Benefits Outlined

The benefits offered to small businesses as a result of the passage of health reform include:

• Tax credits: Depending on how many employees they have, and how much they pay them, small businesses may be entitled to tax credits covering as much as 50 percent of their contributions to employee coverage. Small Business Majority, an organization that advocates for small business employers and employees, has set up a calculator on its website to help employers determine the size of this tax credit.
• Wellness grants: Beginning next year, a $200 million, five-year federal grant program will award grants to employers that have established employee wellness programs. The program is designed to encourage employers to promote physical activity, healthy eating habits, and other wellness-related initiatives among their employees.
• Health insurance exchanges: Each state is required to establish a health insurance exchange that will facilitate the purchase of qualified insurance plans. These exchanges will also each maintain a Small Business Health Options Program (SHOP) to further assist small businesses as they attempt to find benefit plans that best meet their employees’ needs.

Other Health Reform Fact Sheets

PHI’s fact sheet on health reform and small businesses is the third in a series of health reform-related fact sheets. The others are:

• Health Reform Facts 1: Workforce Development and Training Opportunities for Direct-Care Workers, which describes several new workforce commissions, federal training grants, and workforce-development programs affecting direct-care workers.
• Health Reform Facts 2: Pre-Existing Condition Insurance Plan, which explains a program that will allow individuals with pre-existing medical conditions to purchase insurance.

– by Matthew Ozga

A new high-risk pool insurance program — the first major health coverage expansion under the Patient Protection and Affordable Care Act of 2010 — will be available starting this summer.

The temporary insurance program, entitled the Pre-Existing Condition Insurance Plan (PCIP), is intended to help people who have been unable to obtain health insurance due to pre-existing medical conditions such as diabetes, hypertension, cancer, or injury.

The program will run until January 1, 2014, when the Affordable Care Act is fully enacted.

A provision in the Affordable Care Act provides $5 billion in federal funding to support state PCIPs for the next four years. States can use the funding to subsidize the costs of running their own PCIP and to reduce premiums for participants.

States also have the option of opting out, in which case the federal government will provide a PCIP for the state’s residents. Twenty states have opted out of running their own high-risk pools.

Details of PCIP, including which states are operating their own PCIP or have opted out, are available in Health Reform Facts 2 (pdf), the second fact sheet in PHI Health Care for Health Care Workers‘ series on how health reform affects direct-care workers and their employers.

Eligibility

In order to be eligible for coverage through PCIP, an individual must meet the following requirements:

• Be a U.S. citizen or legal resident;
• Not have had coverage through a private group or individual health insurance plan, an existing state high-risk pool, COBRA, or a public program like Medicaid for six months prior to applying for coverage; and
• Have a pre-existing condition.

How to Apply

For more information, including full eligibility requirements and application instructions, visit www.pcip.gov.

“I strongly encourage workers to explore their eligibility for this program,” said Carol Regan, national director of the PHI Health Care for Health Care Workers campaign. “This may be an opportunity for some uninsured workers with pre-existing conditions to finally get coverage.”

To receive the Health Reform Fact Sheets as they are released, subscribe to PHI’s Health Care for Health Care Workers email alerts.

– by Deane Beebe

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