Commentary

Tomorrow is National Youth Enrollment Day for the ACA

Despite policymakers’ attempts to repeal all or parts of the Affordable Care Act (ACA) nearly 60 times, the ACA works. Further, both times all or certain provisions of the ACA have been to the Supreme Court, the health care law has remained mostly intact. In 2014, the ACA enhanced the well-being of nearly 460,000 North Carolinians who were able to obtain affordable health care coverage. Open Enrollment 3 started on November 1, 2015 and goes until January 31, 2016. While many residents of the Tar Heel state understand the benefits of the ACA, only 28 percent of enrollees are young adults based on 2014 enrollment data. Tomorrow, January 21st, is National Youth Enrollment Day and advocates of the ACA are encouraging young adults to get covered.

Why should young adults enroll in the ACA?

  • Even though the ACA allows youth until age 26 years to remain on their parents’ insurance, adults between the ages of 19 and 34 years are still the most likely to be uninsured.
    • Many pediatricians will continue seeing patients until they complete secondary school and college or until 18 to 21 years. For many young adults, once they leave pediatric care, they do not have a regular primary care doctor until their 30s and 40s.
  • Young adults are the least likely to have a health care home. Individuals who do not have a regular place to seek health care are more likely to rely on urgent or emergency care.
  • You can shop the Marketplace to find a coverage plan that fits your budget. This is especially important because…
    • Young adults were the hardest hit by the Great Recession, thus increasing the need for financial help in obtaining care through the ACA;
    • The average amount of financial help North Carolinians receive is $315 per month;
    • The penalty for not obtaining health care coverage has increased to $695 per person or 2.5 percent of one’s household income, whichever is higher. For more information please visit: https://www.healthcare.gov/fees/fee-for-not-being-covered/ or call: 1-855-733-3711;
    • As of November 2015, 81 percent of ACA enrollees from NC selected plans that cost less than $75 per month.
  • Health care coverage offers one peace of mind…
    • No longer have to worry about whether you can access affordable or quality care when you need it;
    • No longer have to worry about waiting until a health concern becomes severe or chronic and thus more costly;
    • No longer have to worry about bankruptcy or the financial burden from medical bills if you or a loved one gets sick.
  • Affordable health coverage helps young adults access primary care preventative care…

There are 11 days left to enroll, please visit healthcare.gov to start the enrollment process!

Commentary

An early start to your New Year’s resolutions: Get health coverage

Enroll America

Image: www.enrollamerica.org

Despite policymakers’ attempts to repeal all or parts of the Affordable Care Act (ACA) nearly 60 times, the ACA works. What’s more, the law is clearly here to stay. On both occasions that all or specific provisions of the ACA have been to the Supreme Court, the health care law has remained largely intact. In 2014, the ACA enhanced the well-being of nearly 460,000 North Carolinians who were able to obtain affordable health care coverage.

Now, it’s time once again for the uninsured to enroll. Open Enrollment 3 started on November 1 and goes until January 31, 2016. As of December 5, nearly 200,000 people in North Carolina had applied for health care coverage through the Marketplace. Today, December 15, is the deadline to enroll for health coverage starting on January 1, 2016.

Even though there has been much attention paid to increasing premiums for coverage purchased through the Marketplace, many North Carolinians will still receive financial help. The average amount of financial assistance received by ACA enrollees is $315 per month. Further, the majority of enrollees selected plans costing less than $75 per month.

Another fiscal consideration is that the penalty for not enrolling in a plan is increasing to $695 per person or 2.5 percent of one’s household income, whichever is higher. 2016 will also be the first year that people will not receive an additional grace period or special enrollment period around the tax deadline. Even though the financial impact of obtaining health coverage is significant for many households and individuals, having access to health care gives one peace of mind. The ACA mandates the coverage of essential health benefits ranging from maternity and newborn care to mental health and substance use disorder treatment.

Unfortunately, hundreds of thousands of North Carolinians will not qualify for health coverage through the ACA, do not have access to employer based health insurance, and are ineligible for Medicaid. Our state policymakers have failed to extend health coverage through Medicaid expansion to home health care workers, parents, office clerks, and school bus drivers.

One year ago, the Cone Health Foundation released a report highlighting the benefits of Medicaid expansion. If our state legislators would have chosen to expand Medicaid, 29,000 jobs would have been created this year. In addition to the approximately 200,000 (and counting) North Carolinians who will have health coverage starting in the new year by enrolling in the ACA, according to the report 300,000 people would have gained health coverage if policymakers had decided to expand Medicaid this year. Let’s start 2016 on a healthy note, enroll for health coverage today and encourage your state policymakers to expand Medicaid to 500,000 North Carolinians in the coverage gap.

Commentary

Honor our veterans with health care

VetHealthNorth Carolina ranks 8th for veteran population as there are nearly 800,000 veterans living in the Tar Heel state. The VA reports that in 2014 there were four VA Hospitals, six Vet Centers, and sixteen community-based outpatient clinics throughout the state. Given the veteran population, it is easy to see why the VA Secretary, Robert McDonald, has reported much difficulty in meeting demands for veteran health care with limited resources and facilities. In North Carolina, only 321,459 veterans are enrolled in the VA Health Care System and only 214,215 patients were reported as treated in North Carolina in 2014.

Further, 316,000 veterans are aged 65 years and over and thus qualify for Medicare, which makes it easier to access health care outside of the VA Health Care System. Unfortunately, there are too many veterans that have difficulty accessing care and with statistics showing that one out of every ten veterans under age 65 years do not use VA health care and do not have health insurance shows that the United States has much room to improve how we care for those who have served this country. Fortunately, with the passage of the Affordable Care Act (ACA), a pathway did open to make health care to veterans more affordable and accessible. The pathway is Medicaid Expansion. Research has shown that four out of every ten uninsured veterans fall into the Medicaid coverage gap. This means that many veterans and their spouses make too much money to qualify for Medicaid (note: there are additional criteria for Medicaid eligibility) and too little to qualify for financial help or subsidies to enroll in the ACA through the Marketplace.

A report by the Robert Wood Johnson Foundation that used data from the 2008-2010 American Community Survey, show that there are approximate 23,000 veterans in North Carolina that would benefit from Medicaid Expansion. Approximately, 8,000 spouses of veterans would also be able to access affordable health care if North Carolina expands Medicaid. So as we honor those who have fought and served our country tomorrow, let’s not forget that North Carolina has an opportunity to protect our veterans and their families’ health by closing the coverage gap. As Medicaid reform moves forward, our policymakers can include Medicaid expansion so that veterans’ mental and physical health is protected.

Commentary

This Halloween we’ve had enough of ACA ghost stories and scare tactics

Action NC policy and public affairs director Kevin Rogers has an opinion piece in the News & Observer arguing that the ACA is here to stay, so we should get down to the business of improving the law and fully implementing it in North Carolina.

Open enrollment, he reminds us, starts November 1. Our state is a national leader when it comes to signing up residents for Affordable Care Act plans. The many people who have these policies need added protections, not repeal votes, to make their insurance plans work better. And the working poor need our state leaders to stop blocking Medicaid expansion. This interposition is causing great pain, and unnecessary deaths, all across North Carolina.

You can read the entire editorial here. Rogers concludes with this message to lawmakers:

As we enter the third ACA enrollment period, it is high time for Congress and the General Assembly to accept reality, abandon partisan tricks and move forward to improve the economic and human well-being of our state. Until then, thousands of lives will be lost each year, and billions of dollars wasted that health care consumers, taxpayers and our government cannot afford. The ACA is here to stay – it’s time to start acting accordingly.

If they heed his advice that would be sweet indeed.

Commentary

Failing to expand Medicaid costs more

In addition to extending health care coverage to nearly a half million people, creating over 40,000 jobs by 2020, and preventing nearly 15,000 families from facing catastrophic medical bills annually, new data from the Kaiser Family Foundation shows that Medicaid expansion actually helps slow state Medicaid spending growth.

A survey of Medicaid directors in all 50 states showed that Medicaid expansion states only saw a 3.4 percent increase in state Medicaid spending growth compared to non-expansion states like North Carolina that experienced on average a 6.9 percent increase in state spending growth. What is more, Medicaid expansion states were still able to control Medicaid spending growth despite Medicaid enrollment increasing by 18 percent.

State spending growth in expansion states is less because the federal government continues to cover 100 percent of Medicaid costs through 2016 for expansion states. Starting in 2020, the federal government‘s contribution will remain at 90 percent. For non-expansion states, the federal government contributes much less. For example, the contribution from the federal government for Medicaid only increased 0.36 percentage points from 65.88 percent in fiscal year 2015 to 66.24 in fiscal year 2016. With only a slight increase in federal support for Medicaid, North Carolina will have to spend more as Medicaid enrollment continues to grow. The average monthly Medicaid and CHIP enrollment before the ACA was 1,595,952 and in July 2015 enrollment was reported at 1,911,334 individuals. Considering that there is a 20 percent change in Medicaid enrollment growth, North Carolina policymakers, especially our governor must develop a plan to address Medicaid spending and enrollment growth.

This past legislative session, the legislature passed a short-sighted Medicaid Reform bill that is supposed to increase budget predictability and control costs. More specifically, the bill states that North Carolina’s “risk-adjusted cost growth for its enrollees must be at least two percentage (2%) points below the national Medicaid spending growth…”. However, failing to expand Medicaid and rejecting $2 billion dollars in federal funding annually will act as a major barrier to decreasing spending growth below the national average.

But, it is not too late for North Carolina to expand Medicaid to help control spending growth. A Medicaid expansion plan that is tailored to meet North Carolina’s needs can be added to the Medicaid reform plan waiver that will be submitted to the federal government. In other words our state can reform and expand Medicaid at the same time. These data prove that our state policymakers can no longer use the excuse that Medicaid expansion burdens state budgets. If anything, failing to close the coverage gap through Medicaid expansion strains North Carolina’s budget.