Health Insurance Navigator Groups Announced

By Amanda Robinson

Reviewed by Lisa Zamosky

WebMD Health News

Aug. 16, 2013 — The Department of Health and Human Services (HHS) has awarded $67 million in grants to 105 organizations that will help people buy health insurance and understand their options in the new health insurance Marketplaces. The grants will go to health care providers, nonprofit organizations, and business groups in 34 states to train insurance “navigators” as part of the Affordable Care Act. The grants are for states where the federal government will run the Marketplace and for states that are partnering with the feds. States that run their own Marketplaces have separate navigator programs.Navigators are supposed to be fair and unbiased helpers who may not accept money from insurance companies. They must complete 20 to 30 hours of training and be certified by the state.

In July, the HHS also awarded $150 million to more than 1,000 community health centers and clinics to help people buy insurance in the Marketplaces, also called Exchanges. Insurance brokers also can assist people with their insurance questions and help them sign up for a health plan through their state’s Marketplace.

Here is the full list of organizations and their expected grants:

Alaska

• Alaska Native Tribal Health Consortium, $300,000
• United Way of Anchorage, $299,918

Alabama

• Ascension Health*, $202,706
• AIDS Alabama, Inc., $501,380
• Samford University, $326,794
• Catholic Social Services (Archdiocese of Mobile), $20,750
• Tombigbee Healthcare Authority, $392,356

Arkansas

• Southern United Neighborhoods*, $270,193
• University of Arkansas (The Arkansas Navigator Coalition), $774,745

Arizona

• Arizona Association of Community Health Centers, $1,344,096
• Arizona Board of Regents, University of Arizona (Center for Rural Health at the University of Arizona), $190,268
• Greater Phoenix Urban League, Inc., $523,773
• Campesinos Sin Fronteras, Inc., $71,386

Delaware

• Chatman, LLC, $510,577

Florida

• University of South Florida (Florida Covering Kids & Families), $4,213,696
• Epilepsy Foundation of Florida, $637,686
• Advanced Patient Advocacy, LLC*, $413,152.20
• Legal Aid Society of Palm Beach County, Inc., $446,783
• Pinellas County Board of County Commissioners, $600,000
• National Hispanic Council on Aging*, $646,825.50
• Cardon Healthcare Network, LLC DBA Cardon Outreach*, $238,000
• Mental Health America*, $683,691

Georgia

• Structured Employment Economic Development Corporation, $2,159,360
• University of Georgia (College of Family and Consumer Sciences and Cooperative Extension Service), $1,657,378

Iowa

• Genesis Health System*, $128,430
• Visiting Nurse Services of Iowa, $257,142
• Planned Parenthood of the Heartland*, $214,427

Illinois

• Genesis Health System*, $137,283
• Sinai Health System, $157,271
• DuPage County Health Department, $182,543
• Southern Illinois Healthcare Foundation, $240,113
• A Safe Haven Foundation, $324,736
• Mercy Hospital and Medical Center, $452,590
• The Puerto Rican Cultural Center, Inc., $600,000
• Illinois College of Optometry, $504,016
• VNA Health Care, $132,737
• The East Los Angeles Community Union, $294,182
• National Council of Urban Indian Health*, $35,000

Indiana

• Affiliated Service Providers of Indiana, Inc., $897,150
• Plus One Enterprise, LTD, LLC, $130,875
• Health and Hospital Corporation of Marion County, $590,985
• United Way Worldwide, $424,586

Kansas

• Advanced Patient Advocacy, LLC*, $195,556
• Ascension Health*, $165,683
• Kansas Association for the Medically Underserved, $524,846

Louisiana

• Southern United Neighborhoods*, $486,123
• Martin Luther King Health Center, Inc., $81,066
• Southwest Louisiana Area Health Education Center, $1,099,985.80
• Capital Area Agency on Aging, District II, Inc., $100,000

Maine

• Western Maine Community Action, $475,000
• Fishing Partnership Health Plan, $66,846

Michigan

• Community Bridges Management Inc., $896,366
• Arab Community Center for Economic & Social Services, $276,593
• American Indian Health & Family Services of SE Michigan, Inc., $49,583.50
• Michigan Consumers for Healthcare, $1,319,345

Missouri

• Primaris Healthcare Business Solutions, $1,045,624
• Missouri Alliance of Area Agencies on Aging, $750,000

Mississippi

• Oak Hill Missionary Baptist Church Ministries, $317,742
• University of Mississippi Medical Center, $831,986

Montana

• Intermountain Planned Parenthood, Inc., $295,604
• Montana Primary Care Association, Inc., $299,382
• Rural Health Development DBA Montana Health Network, $143,076

North Carolina

• Randolph Hospital, Inc., $352,320
• Mountain Projects, Inc., $359,750
• North Carolina Community Care Networks, $1,988,428
• Alcohol/Drug Council of North Carolina, $324,798

North Dakota

• Great Plains Tribal Chairmen’s Health Board*, $186,000
• Minot State University, North Dakota Center for Persons with Disabilities, $414,000

Nebraska

• Community Action of Nebraska, Inc., $562,457
• Ponca Tribe of Nebraska, $37,543

New Hampshire

• Bi-State Primary Care Association, $434,839
• Planned Parenthood of Northern New England, $145,161

New Jersey

• Center for Family Services, Inc., $677,797
• Wendy Sykes – Orange ACA Navigator Project, $239,810
• The Urban League of Hudson County, $565,000
• Public Health Solutions, $400,583
• FoodBank of Monmouth and Ocean Counties, Inc., $137,217

Ohio

• Ohio Association of Foodbanks, $1,958,961
• Children’s Hospital Medical Center, $124,419
• Clermont Recovery Center, Inc., $44,938
• Helping Hands Community Outreach Center, $230,920
• Neighborhood Health Association, $684,630

Oklahoma

• Cardon Healthcare Network, LLC DBA Cardon Outreach*, $178,500
• Oklahoma Community Health Centers, Inc., $860,866
• Little Dixie Community Action Agency, Inc., $580,733

Pennsylvania

• Resources for Human Development, Inc., $953,176
• Pennsylvania Association of Community Health Centers, $694,380
• Pennsylvania Mental Health Consumers’ Association, $380,000
• Cardon Healthcare Network, LLC DBA Cardon Outreach*, $178,500
• Mental Health America*, $503,129

South Carolina

• DECO Recovery Management LLC, $1,211,203
• The Cooperative Ministry, $508,313
• Beaufort County Black Chamber of Commerce, $234,099.21

South Dakota

• South Dakota Community Action Partnership, $336,000
• Great Plains Tribal Chairmen’s Health Board*, $264,000

Tennessee

• Structured Employment Economic Development Corporation*, $1,216,013
• Tennessee Primary Care Association, $781,265

Texas

• United Way of Metropolitan Tarrant County, $5,889,181
• Migrant Health Promotion, Inc., $589,750
• National Hispanic Council on Aging*, $646,825
• Change Happens, $785,000
• United Way of El Paso County, $642,121
• Southern United Neighborhoods*, $600,678
• East Texas Behavioral Healthcare Network, $1,337,520
• National Urban League, 376,800

Utah

• Utah Healthy Policy Project, $406,788
• Utah AIDS Foundation, $126,258
• Cardon Healthcare Network, LLC DBA Cardon Outreach, $238,000
• National Council of Urban Indian Health*, $35,000

Virginia

• Virginia Poverty Law Center, Inc., $1,278,592
• Advanced Patient Advocacy, LLC*, $483,433

Wisconsin

• Partners for Community Development, Inc., $315,720
• Northwest Wisconsin Concentrated Employment Program, Inc., $285,035
• Legal Action of Wisconsin, Inc./SeniorLAW, $70,000
• National Council of Urban Indian Health*, $35,000
• National Healthy Start Association, $191,667
• R&B Receivables Management Corporation DBA R&B Solutions, $104,520

West Virginia

• Advanced Patient Advocacy, LLC*, $276,617
• West Virginia Parent Training and Information, Inc., $365,758

Wyoming

• Memorial Hospital of Laramie County DBA Cheyenne Regional, $401,281
• Wyoming Senior Citizens, Inc., $198,719

(*) Organization is operating in more than one state

6 Surprises From Health Insurance Reform

By Jay MacDonald

Published August 16, 2013

Bankrate.com

Mere months before major elements of the historic Affordable Care Act take effect, polls show that many Americans still don’t understand the basics of health insurance reform or the impact it will have on their lives.

As plans take shape for the opening of the first-ever public health insurance exchanges this October, the picture is slowly becoming clearer as to how President Barack Obama’s ambitious, intricately layered health care overhaul will affect the nation. Some of the impacts have seemed a bit surprising, even unfortunate.

“No single law can solve all problems,” says Linda Blumberg, a health economist and senior fellow at the Urban Institute, a Washington, D.C., think tank. “We have to take things one step at a time and know that this is going to be a continuing process of trying to reform a system that has flaws, with markets that aren’t now and never have been competitive, and evolve to (a) more efficient provision of high-quality care.”

With the full effect of health care reform just months away, here are six Obamacare consequences that are coming to light — some unforeseen, others that only seem that way.

You could lose your existing health plan

In 2009, Obama reassured Americans, “If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.”

So why are some insurers notifying policyholders that their health plan is being discontinued?

The short answer: Insurers are phasing out some plans and are replacing them with others designed to meet the new federal minimum value and affordability standards for individual and small-business plans under health insurance reform.

Technically, you can still hold onto your policy, thanks to language in the law that allowed existing health plans to be “grandfathered” in, thus exempting them from the new requirements. But experts say once you’re offered better coverage for less, why wouldn’t you make a move?

“You can keep that policy, but you may very well not want to,” says Blumberg. “A lot of people are going to be making the proactive decision to leave them, so they’ll diminish pretty significantly over time.”

Big employers may offer bare-bones coverage

Large companies with many low-income and currently uninsured workers, such as restaurant chains and retailers, are flirting with offering a barely qualifying version of barely there “mini-med” health coverage to sidestep Obamacare’s $2,000-$3,000 per-employee penalty for failing to offer qualifying coverage.

That “employer mandate” was to take effect Jan. 1 but has been delayed until 2015.

Incorporating so-called skinny coverage that may not take care of X-rays, surgery or maternity care is just one of several cost-cutting options that large employers are exploring to offset the additional expenses of health reform.

Tracy Watts, national health care reform leader at Mercer, a global research and consulting firm, says the goal for these employers is to design a bare-bones plan that costs them less than the penalty for not offering coverage and doesn’t appear too enticing to those who currently opt out of coverage or insure through their spouse.

“The question is, how many people would have to enroll before you would spend as much as you would on the $2,000 penalty, and do you think that many people would enroll?” she says.

Hospital mergers may thwart reform goals

The recent trend toward hospital consolidation would seem to work at cross purposes with health insurance reform’s central mission of seeding the private health care market with incentives that will blossom into better care at a lower cost. After all, studies have shown that when hospitals merge, just the opposite happens: Prices go up, and quality can falter.

According to the American Hospital Association, more than 550 hospitals have been acquired since 2007. A similar spike in mergers and acquisitions followed the rise of health maintenance organizations, or HMOs, in the mid-1990s.

“If you have more and more consolidation of providers (hospitals), it makes it more difficult for insurers to be tough price negotiators,” says Blumberg.

“Even if an insurer has 80% of a market, if they’re dealing with a single must-have provider system in a particular area, that provider could say, ‘You can tell me what you’re going to pay me all you want, but here’s what I’m going to accept.'”

Short of regulating prices, which is currently a political nonstarter, Blumberg says hospital consolidation “is an issue we’re going to continue to struggle with.”

Young people may benefit most from Obamacare

Despite dire predictions of “rate shock” for millennials, most of today’s young adults are best positioned to benefit from health care reform, thanks to federal subsidies that should make quality health insurance affordable for this largely unmarried, lower-earning population beginning in 2014.

Jen Mishory, deputy director of Young Invincibles, a young adult advocacy group based in Washington, D.C., says there are an estimated 21 million young Americans who are uninsured, and the overwhelming majority of them have incomes in the low-to-moderate range. Most will be eligible to purchase affordable coverage with federal assistance through the new state exchanges, beginning with early enrollment in October.

Many millennials who do have health coverage are insured through a parent’s plan until they turn 26 — another perk of health care reform.

“Young people are going to disproportionately be the largest beneficiaries of the Affordable Care Act,” predicts Ron Pollack, executive director of the health care consumer group Families USA.

Tax on ‘Cadillac’ plans hits middle class

Millions of Americans anticipate buying health insurance for the first time through new public exchanges to avoid penalties for not having insurance under health care reform’s “individual mandate” that takes effect in January. At the same time, some employers are already scaling back their group health plans to avoid a 40% excise tax on high-cost, or “Cadillac,” plans that doesn’t take effect until 2018.

The tax will hit individual plans costing more than $10,200 and family coverage costing more than $27,500 annually. A Washington, D.C.-based think tank, the Economic Policy Institute, has criticized the tax as “not well-targeted” because it’s likely to impact many unsuspecting workers with rather ordinary health plans that happen to cost a lot because of company size, job location and other factors.

The institute says the tax creates a strong incentive for employers to move toward cheaper and less-generous coverage that shifts more costs onto workers.

Watts says “about a third” of companies are making corrections now to keep their “Cadillac” plans out of the ditch, with most moving toward “consumer-driven” platforms in which employees are given a fixed sum and allowed to shop for their best health and benefits fit.

Obamacare could be good for entrepreneurs

“Job lock” aptly describes the economic force that keeps employees tied to a job for the health care coverage.

The Affordable Care Act may provide “job unlock.” A new study by the Robert Wood Johnson Foundation, the Urban Institute and the Center on Health Insurance Reforms at Georgetown University finds that health insurance reform will likely unleash 1.5 million Americans to pursue their entrepreneurial dreams.

“In the vast majority of states right now, the nongroup insurance market is very dysfunctional for a lot of people,” says Blumberg, the lead author of the study. “What the Affordable Care Act does — by creating a stable, affordable and adequate nongroup market — is it frees lots of people to make different types of work decisions than they are able to make today.”

Mishory says that’s great news for young people.

“Young people switch jobs so much as they’re building careers that the ability to do that without worrying about health insurance is huge,” she says. “They’ll be able to carve a career path that works for them and has potential positive economic impact as well.”

Read more: http://www.foxbusiness.com/personal-finance/2013/08/15/6-surprises-from-health-insurance-reform/#ixzz2c9QNWzWo

Study: Affordable Care Act Tax Credits to Average $2,700

GOVERNMENT/LAW 08/16/2013 | by Bradford Pearson

Families who buy their own insurance instead of obtaining it through an employer will receive an average tax credit of close to $2,700 starting next year, according to a new Kaiser Family Foundation study.

The tax credits are part of federal officials’ strategy for making coverage in the new Affordable Care Act-mandated health insurance marketplaces more affordable for low to middle-income families.

According to the Kaiser Family Foundation, the average tax credit of $2,672 would cover 32 percent of the average premium for a family purchasing a “silver” plan on the new exchanges. People will be eligible if they have incomes between $11,500 and $46,000 as an individual, or between $24,000 and $94,000 as a four-person family.

Source Link:  http://healthcare.dmagazine.com/2013/08/16/study-affordable-care-act-tax-credits-to-average-2700/

 

Understanding Obamacare: 5 Facts About the ‘Affordable Care Act’

IGNORE ALL THE POLITICAL BACK AND FORTH AND FIND OUT FOR YOURSELF WHAT THE AFFORDABLE CARE ACT MEANS FOR YOU AND YOURS

Read more at EBONY http://www.ebony.com/wellness-empowerment/understanding-obamacare-5-facts-about-the-affordable-care-act-987#ixzz2c8aKLw4s
Follow us: @EbonyMag on Twitter | EbonyMag on Facebook

We’ve heard about it in bits and pieces over the past three years —the Affordable Care Act  (ACA) also known as “Obamacare.” The political spectacle around this legislation is one thing, but what’s more important is understanding the specific details and making sense of what it really means to you. Fortunately, AARP is here to untangle the jargon and empower EBONY.com readers with the answers and information that nightly news bites don’t offer. Whether you are a senior citizen or a millennial, the Affordable Care Act can have serious impact on your health care, so take notes!

Beginning Jan. 1, 2014, the ACA will provide 6.8 million uninsured African-Americans an opportunity to get affordable health insurance coverage. The bottom line is if you are not insured, low cost or free plans will soon be available. If you already have insurance, you may be able to find an even more affordable plan.

Here are 5 facts about the ACA or “Obamacare”:

• 3.1 million young adults have gained coverage through their parents’ health insurance plans. This includes more than 500,000 young African-American adults between ages 19 and 25, according to the U. S. Department of Health and Human Services (HHS).
• 6.3 million seniors are paying less for prescription drugs. And if you have Medicare Part D, and you reach the coverage gap or “doughnut hole” in 2013, you will get more than a 50 percent discount on brand name prescription drugs and more than a 20 percent discount on generic drugs while in the coverage gap. The discounts will continue until 2020 when the gap will end.
• 105 million Americans are paying less for preventative care and no longer face limits on lifetime coverage, according to HHS. The 4.5 million elderly and disabled African-Americans who receive health coverage from Medicare also have access to many preventive services with no cost-sharing, including annual wellness visits with personalized prevention plans, diabetes and colorectal cancer screening, bone mass measurement and mammograms, according to HHS.
• 17 million children with pre-existing conditions are no longer denied coverage or charged extra. The issue of pre-existing conditions has been a consistent barrier to obtaining insurance. Under the ACA, beginning in 2014, insurance companies can no longer deny you coverage, even if you have a pre-existing condition like asthma, diabetes, high-blood pressure or even cancer. And if you or a family member gets sick or injured, insurance companies can’t cut off your coverage or cancel your plan.
• ACA will provide greater access to affordable quality health care, and will also “invest in prevention and wellness, and give individuals and families more control over their care,” according to HHS. Because African-Americans suffer from diseases such as obesity, heart disease, and diabetes at higher levels than America’s general population, this is a critical component of the plan.

So how do you get started with the benefits? Starting October 1, 2013, you can log on to HeathCare.gov, and search the newly formed “Health Insurance Marketplace.” The website will present competing insurance agencies and help guide health care seekers—individuals, families and small businesses —to the best decisions on which plan to choose or switch over to.

For more information about the Affordable Care Act and how the law applies to you, visit AARP’s HealthLawAnswers.org Our goal is to make it plain.

Read more at EBONY http://www.ebony.com/wellness-empowerment/understanding-obamacare-5-facts-about-the-affordable-care-act-987#ixzz2c8aNmPVn
Follow us: @EbonyMag on Twitter | EbonyMag on Facebook

$67M doled out to those aiding others navigate health care

Kelly Kennedy, USA TODAY8:25 a.m. EDT August 16, 2013

STORY HIGHLIGHTS

• Grants go to organizations that help Americans with the new health care law
• The government estimates at least 7 million will buy insurance through the exchanges
• Exchanges are state websites where people can shop for various policies

TAMPA — The Department of Health and Human Services on Thursday awarded $67 million in grants to 105 navigators, or groups of people who will help uninsured Americans sign up for health insurance beginning in October.

HHS Secretary Kathleen Sebelius made the announcement at the University of South Florida, which received a $4 million grant. Eight groups in Florida will receive a total of $7.8 million.

Florida is one of the three states where federal officials hope to add millions of young, uninsured and healthy adults to the pool of people who will buy health insurance through the state exchanges created by the 2010 health care law. California and Texas are the other two states.

“We know that a lot of people prefer in-person help,” Sebelius said of the navigators, adding that the helpers will receive an initial 20 hours of training, as well as additional training throughout the year.

“We know there’s a lot of work to be done, but we’ll be ready for whatever comes up,” she said.

The grants come as the law’s supporters and opponents argue about its merits and potential impact. Organizing for Action, the non-profit political group backing President Obama, released a third advertisement to explain the law’s benefits, while Crossroads GPS, a political group created by Republican strategist Karl Rove, continues its media campaign criticizing the law.

Some Republican officials, including Sen. Ted Cruz of Texas, are calling for a government shutdown at the end of September to stop funding for the law, a move that other Republican officials are calling counterproductive and suicidal for the party’s chances.

HHS looks for groups who already have networks in place, who already have connections” to be navigators, Sebelius said. “We had lots more people apply than we could fund,” she said.

Sebelius also recognized Thursday the more than 100 volunteer organizations educating people about the exchanges. The exchanges are online marketplaces where people may buy health insurance from private companies. At healthcare.gov, consumers can compare benefits and costs of several plans. They will also be able to see whether they qualify for a subsidy to help pay for insurance.

HHS officials have tried to keep the process of buying insurance but acknowledge that many Americans will still need help. A recent survey found that just 14% of Americans understood basic insurance terms, such as “premium” and “deductible.”

Often, people have been shut out of the insurance system because of pre-existing medical conditions, poverty or simply not being able to quickly choose a plan because information was not available.

Across the nation, the states have also taken a role in advertising the law. In the District of Columbia, exchange spokesman Richard Sorian said, about 35 organizations have received training to help people enroll, and a call center will be open 24 hours a day and seven days a week to answer questions, because some people who may be eligible for subsidies may work two or three jobs.

District officials have also asked for help from community leaders, such as churches, African-American groups, African-immigrant organizations and LGBT groups, as well as the Chamber of Commerce and the restaurant association.

“We see the population that is uninsured as fairly hard to reach,” Sorian said. “So we’re taking a systematic approach.”

In Hawaii, the state will start running television advertisements and they are making presentations to community organizations that will also promote the exchanges, said Brian Fitzgerald, spokesman for the Hawaii Health Connector.

“I think people are just now realizing the law takes effect Jan. 1, and they’re saying, ‘What do I need to do?'” he said. “There’s a lot of excitement.”

Illinois has just started training its navigators, and 44 community organizations will help enroll people in insurance, state health care spokesman Mike Claffey said.

In Maryland, officials are training 325 navigators and 5,000 aides known as “assistors,” said Danielle Davis, spokeswoman for the Maryland Health Connection, beginning the last week in August.

In Arkansas, the Health Connector website launched July 1 and has had 91,000 individual hits.

“We’ve had robust outreach in every county,” said Deputy Insurance Commissioner Cindy Crone. “We’ve had a lot of positive response.”

They have a state “guide” program to help the federal navigator program, but state legislators decided all of those who assist people must have licenses.

The federal government has also launched a 24-hour-a-day call center, and 1,200 community health centers are also working to educate people.

Navigators must follow strict security and privacy standards to protect personal information, such as Social Security numbers and income, Sebelius said.

On Thursday, she recognized organizations, such as the American Medical Association, NAACP, League of United Latin American Citizens and the National Baptist Convention, that are working to inform people about the exchanges.

Follow @KellySKennedy on Twitter

Source Link:  http://www.usatoday.com/story/news/politics/2013/08/15/navigators-affordable-care-act/2658753/