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SEPTEMBER 2013
Vol. 58, No. 8

 

Affordable Care Act

Open enrollment begins October 1

NASW members urged to educate clients and communities about new health insurance options
Health Insurance Marketplace

The major provisions of the Affordable Care Act, which aims to ensure that all Americans have health insurance, will go into effect Jan. 1. The next significant step in implementing the law is the open enrollment process for health care coverage, which begins Oct. 1.

Open enrollment is an opportunity for people without insurance to explore different options and determine which is right for them. Coverage begins on Jan. 1 for new enrollees.

“Consumers will have many avenues for exploring coverage options,” NASW Senior Practice Associate Stacy Collins said. 

At the federal level, the “health insurance marketplace” website (www.healthcare.gov) is a portal where individual and families can determine their eligibility for different health insurance programs, including Medicaid, the Children’s Health Insurance Program and qualified health plans within their states, Collins said.

“The Marketplace portal is a great tool for people to review and compare insurance plans and determine the best fit, based on their needs and budgets,” Collins said, adding that many people will qualify for federal tax subsidies to purchase plans on the health insurance marketplace, depending on their incomes.

Each state will also have its own enrollment system, using health insurance navigators and application counselors, to assist consumers in enrolling in coverage. In addition, many states will have their own insurance marketplace portals.

“Whether they work in health care and behavioral health settings, child welfare departments, social service agencies, criminal justice, academia, or private practice, all social workers will encounter people who are uninsured,” Collins said. “Therefore, social workers need to understand the ACA enrollment process.”

There are a variety of resources to help social workers become familiar with and promote the enrollment process. Marketplace.cms.gov has enrollment resources for professionals, including posters, fact sheets, website widgets, informational videos, and brochures published in multiple languages. Other websites that offer social workers open enrollment resources include www.enrollamerica.org and www.familiesusa.org.

NASW also is participating, under the leadership of the Substance Abuse and Mental Health Services Administration, on the Criminal Justice and the Mental Health/Substance Abuse Affordable Care Act Enrollment Coalitions, said Mel Wilson, manager of NASW’s Department of Social Justice and Human Rights. The coalitions comprise a number of national criminal justice and behavioral health provider organizations, national associations and government agencies that have the capacity to disseminate detailed ACA enrollment information to a large number of professionals, he said.

The key objective for SAMHSA, NASW and other coalition members is to ensure that service providers who have direct contact with uninsured behavioral health and criminal justice clients are well informed about the benefits of the ACA, and encourage their clients to apply for ACA benefits beginning Oct. 1, Wilson said.

“The primary vehicle for disseminating information is via an ACA enrollment tool kit, which was developed by SAMHSA and reviewed by coalition members, including NASW,” he said. “The tool kit contains comprehensive details about ACA eligibility, the range of benefits available to the target population, and the enrollment process, among other information.

The tool kit will be available for dissemination by coalition members and was expected to be posted on healthcare.gov by mid-August.

NASW members can use the material from all of these sites to educate themselves on open enrollment and get the necessary information out to those currently uninsured, helping them as necessary with the process to get health care coverage.

For more information on the ACA, please see these NASW Practice Department resources:

In other ACA news:
  • NASW Senior Practice Associate Stacy Collins presented at the National Association of Perinatal Social Workers conference in May to update social workers on health care reform issues as they relate to perinatal settings.
    Collins discussed health reform benefits for mothers and babies, including coverage for young mothers up to the age of 26 on their parents’ health insurance plans, and broadening coverage for younger working mothers who do not qualify for Medicaid. The presentation took place in Baltimore.
    Collins also participated on a health reform panel in June, hosted by NASW’s New York City Chapter and  the Silberman School of Social Work at Hunter College in Manhattan. She discussed the national perspective on the Affordable Care Act and the implications for social workers and the populations they serve.
  • NASW-California Executive Director Janlee Wong gave a presentation in May for the Association of Oncology Social Work on the basics of the ACA, its current status and progress, and its implications for social workers.
    Wong said attendees expressed concern about the decision by many states not to set up a health care exchange and expand Medicaid. About 27 states are defaulting to the federal government to set up an exchange for them, and about 24 states are moving to expand Medicaid under the ACA, Wong said.
    He advised social workers to check with their exchanges for the available health care plans and to learn the details of coverage for those plans.
    “Social workers were given information on advocacy regarding the expansion of Medicaid in their state,” he said.  Oncology social workers were also interested in the details of what the ACA will cover as far as rehab cancer services in exchange plans. The presentation took place in San Diego.

HHS announces $67 million in Navigator grants

The Tennessee Primary Care Association in Brentwood, Tenn., recently received $800,000 as part of the U.S. Department of Health and Human Services grant awards to 105 navigator applicants. NASW member Kathy Wood-Dobbins is CEO of TPCA, which unites health centers and other care providers in an effort to improve access for the medically underserved in the state.

On Aug. 15, HHS announced a total of $67 million in grant money to the 105 navigator applicants, who will use the funds to serve as in-person resources for Americans who want additional assistance in shopping for and enrolling in plans in the health insurance marketplace beginning this fall.

Navigators will be among the many resources available to help consumers understand their coverage options in the marketplace, HHS Secretary Kathleen Sebelius says in the release. “A network of volunteers on the ground in every state — health care providers, business leaders, faith leaders, community groups, advocates, and local elected officials — can help spread the word and encourage their neighbors to get enrolled,” Sebelius said.

Wood-Dobbins said her organization is thrilled to be able to provide navigation resources “not only to patients who already utilize Tennessee’s community health centers, but also to others in the surrounding communities and counties who will be signing up for health insurance — many possibly for the first time.”

“The navigators will work to put a familiar face on what might be considered a complex and unfamiliar process, she said, and will help people understand all the options available to them.”

Visit healthcare.gov

 
 
 
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