Tag Archives: insurance

Buenas tardes,

Over the last several weeks the President has highlighted the benefits of the Affordable Care Act (ACA). With HealthCare.gov now working smoothly for the vast majority of consumers, our top priority is to ensure that every eligible American who wants access to insurance is able to get it. We are two months into a six month open enrollment period and are laser-focused on continuing to reach as many Americans as possible to let them know about their new health care options and the various ways in which they can enroll in the Health Insurance Marketplace.

The need for and interest in affordable health insurance extends across the country. For instance, through November, state and federal websites received 39.1 million visits; we have received applications to provide coverage for approximately 3.7 million individuals; and 2.3 million people were determined eligible to buy a qualified health plan. These numbers remind us that we cannot go back to a system that leaves millions of Americans vulnerable and without care. We must move forward.

President Barack Obama delivers remarks at the White House Youth Summit on the Affordable Care Act (ACA) in the Eisenhower Executive Office Building

President Barack Obama delivers remarks at the White House Youth Summit on the Affordable Care Act (ACA) in the Eisenhower Executive Office Building South Court Auditorium, Dec. 4, 2013. (Official White House Photo by Pete Souza)

As you know millions of people are already benefiting from and will continue to benefit from the Affordable Care Act (ACA). For instance, upwards of 17 million children can no longer be denied coverage due to a pre-existing condition. Additionally, starting in 2014, insurance companies can no longer charge higher premiums based on health status or history. These provisions provide millions of families with the peace of mind to know their children will receive the quality care they deserve.

Also, as a result of changes made by the ACA, millions of Americans are already saving money. For example, the ACA requires insurance companies to spend at least 80% of premiums on medical care and efforts to improve the quality of care. If they don’t, insurers have to send consumers a refund to meet this threshold. Already almost 80 million consumers have saved $3.4 billion upfront on their premiums in 2012; and, based on 2012 spending, 8.5 million customers received an average refund of approximately $100 per family.

The ACA’s commitment to providing health security to all Americans means expanding Medicaid, mental health benefits, and parity protections. Due to the US Supreme Court decision, States can choose whether or not to expand Medicaid coverage to all adults with incomes below 133% of the federal poverty (around $32,000 for a family of four). Already, 26 States and the District of Columbia have expanded Medicaid to provide better care to more of their residents. One thing is clear, Medicaid expansion is both the right and smart choice for states.

Furthermore, for the first time, insurance companies must cover mental health and substance use disorder services at parity with medical and surgical benefits. As such, out-of-pocket costs for behavioral health services must be comparable to coverage for medical and surgical care. That is one of the largest expansions of mental health and substance use disorder coverage in a generation!

In addition to increasing access to health insurance and benefits, the ACA allocated money to increase access to community health centers. Health centers across the country have received funding to create new health center sites in medically underserved areas, to expand preventive and primary health care services, and to support major construction and renovation projects. This important investment supports community health centers double the number of patients they serve to nearly 40 million by 2015. As approximately 35 percent of patients served by community health centers in 2009 were Latino, this investment will positively impact Latinos and help to reduce ethnic and racial disparities in health care.

As HealthCare.gov continues to improve each day for the vast majority of Americans, it’s important to recognize that Americans interested in quality affordable health insurance can purchase health insurance multiple ways. There are four key ways to apply for health insurance: online at HealthCare.gov or CuidadoDeSalud.gov, by telephone at 1-800-318-2596, by mail, and in-person at specified community centers (click here to find local help; En Español). The diversity of application processes allows Americans to select which process works best for them.

4 Ways to Get Marketplace Coverage

As we enter a critical enrollment stage before the holidays, we ask that you to partner with us to amplify the important enrollment deadline of December 23rd to sign up for coverage beginning January 1st, 2014. Even if “health care” isn’t the particular focus of your organization and even if you don’t have grassroots organizers lined up in key markets, there is still something you can do to help people get access to the “gift of health care” this Holiday Season. If you are interested in working with our digital team to send a blast e-mail out to your networks reminding folks to sign-up on HealthCare.gov leading up to the 23rd, please reach out to me at Latino@who.eop.gov.

As always, please share this information with your networks, get engaged in educating the Latino community about the Health Insurance Marketplaces, and use the hashtag: #OurSalud to join the conversation.

Julie Chávez Rodriguez Deputy Director White House | Office of Public Engagement

Agency Updates

How the Marketplace Works Four steps to gaining health coverage. En Español.

Four Ways to get Marketplace Coverage Learn about all the ways to apply for health coverage through the Marketplace. En Español.

#GetCovered: My Story More people are applying and getting coverage from the Health Insurance Marketplace every day. Read personal stories of how the Marketplace has helped people across the country. You can share your story using #GetCovered.

Education Department Releases Updated Financial Aid Shopping Sheet to Provide Students with Additional Transparency in College Costs December 13, 2013 Today, the U.S. Department of Education released an updated version of the administration’s financial aid model award letter, known as the Shopping Sheet, and announced that nearly 2,000 institutions of higher education have voluntarily committed to using this important consumer tool.

The Health Insurance Marketplace: What You Need to Know December 4, 2013 Since it launched in October, we have made dramatic improvements to HealthCare.gov, taking it from a system that didn’t perform nearly as well as it should, to one that can help you learn about your new health insurance options, create an account, learn about financial help you may be able to receive, compare your options and select a plan. If you’ve tried HealthCare.gov and been unsatisfied with your experience, or if you’ve been wondering if you’re eligible for a more affordable option under the health care law, here are some tips for you. Remember, you MUST enroll in a plan by December 23, and pay your premium, to get coverage on January 1, 2014.

United States Agrees to Comprehensive Settlement with Suffolk County Police Department to Resolve Investigation of Discriminatory Policing Against Latinos December 3, 2013 The Civil Rights Division of the U.S. Department of Justice and the U.S. Attorney’s Office for the Eastern District of New York announced today that they have tentatively agreed to a settlement with the Suffolk County Police Department (SCPD) which calls for SCPD to implement new and enhanced policies and procedures to ensure nondiscrimination in the provision of police services to Latino communities in Suffolk County.

FACT SHEET: Youth CareerConnect Grants November 19, 2013 To compete in today’s global economy, America’s students need deep knowledge and skills that will prepare them for college and the jobs of the future. Yet far too many of America’s students are not meaningfully engaged or motivated in their academic experience while in high school. Many high school graduates lack exposure to learning that links their work in school to college and careers—especially in the critically important fields of science, technology, engineering, and mathematics (STEM). Moreover, many of America’s international competitors offer students a more rigorous and relevant education in their middle and high school years.

FACT SHEET: U.S.-Panama Relations November 19, 2013 The United States and Panama share nearly 150 years of history and strong cooperation. Our broad economic, security, and political cooperation reflect the wide range of shared interests.

Blog Highlights

Strengthening Health Centers to Strengthen Our Communities A few weeks ago, I had the privilege of visiting a high-energy forum at a community health center in my home town of Detroit, and saw firsthand how vital community health centers are as a source of quality health care. Today, approximately 1,200 health centers operate more than 9,000 service delivery sites that provide care to over 21 million patients across the country. I am frankly in awe of the great work that these community health centers provide, especially to the Latino and other underserved communities. En Español.

President Obama and the First Lady Will Welcome Two Latino Kennedy Center Honorees to the White House President Obama and the First Lady Michelle Obama will welcome the 2013 Kennedy Center Honorees to the White House this Sunday, December 8, where they will applaud and thank them for their musical contributions to the world. Amongst the five honorees, two of the artists being recognized are Latinos: acclaimed musician Carlos Santana and renowned soprano opera singer Martina Arroyo.

Get Involved

White House Initiative on Educational Excellence for Hispanics Webinar on Family Engagement This month’s webinar will focus on family engagement. The importance of a family’s role in a child’s academic, social, and emotional development is widely accepted and encouraged throughout the education sector. Join us to hear about two program models designed to create strong engagement between families and their children’s schools, and discuss ways to engage Hispanic families in education successfully.

Who: White House Initiative on Educational Excellence for Hispanics What: A WEBINAR on Family Engagement When: Wednesday, December 18, at 2:00-3:10 pm EST Where: To RSVP, email WHIEEH@ed.gov with the subject line: “Family Engagement Webinar”. Please provide your name and organization.

Immigration Integration Project: Call for Applications Networks for Integrating New Americans is an innovative, national initiative that seeks to position adult education programs as key contributors to local, multi-sector networks formed to advance immigrant integration. The initiative will identify, strengthen, and document place-based models of immigrant integration that other communities can replicate and adapt. All materials can be found at: http://www.worlded.org/WEIInternet/us/project/display.cfm?ctid=na&cid=na&tid=40&id=13981.

Who: US Department of Education Office of Vocational and Adult Education What: The project will select up to five forward-thinking community networks (also coalitions or initiatives) to receive technical assistance to address the linguistic, civic, and economic needs of immigrant adults. When: Preliminary applications are due Dec. 20, 2013 Where: Submit application online

White House Internship Program The White House Internship Program provides a unique opportunity to gain valuable professional experience and build leadership skills. This hands-on program is designed to mentor and cultivate today’s young leaders, strengthen their understanding of the Executive Office and prepare them for future public service opportunities. The White House Internship Program’s mission is to make the “People’s House” accessible to future leaders from around the nation.

Who: Young Leaders in the Community What: Opportunity to gain professional experience, build leadership skills, and further exposure to the public service sector. When: Applications due January 5, 2014 Where: Apply online at White House Internship Program Website

Email internship_info@who.eop.gov for more information.

White House Fellows Program Founded in 1964, the White House Fellows program is one of America’s most prestigious programs for leadership and public service. White House Fellowships offer exceptional young men and women first-hand experience working at the highest levels of the federal government. Selected individuals typically spend a year working as a full-time, paid Fellow to senior White House Staff, Cabinet Secretaries and other top-ranking government officials.

Who: Young Leaders in the Community What: The purpose of the White House Fellows program is to provide gifted and highly motivated young Americans with some first-hand experience in the process of governing the Nation and a sense of personal involvement in the leadership of society. When: Applications due January 15, 2014 Where: Apply online at White House Fellows Program Website

Get Updates

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Rape Insurance?

12/13/2013 Nativegrl77

By CAP Action War Room

GOP War on Women, Michigan Edition

After the 2010 elections swept Republicans into power in legislatures across the country, they set about passing an unprecedented number of restrictions — 135 in 2011 and 2012 and 84 more so far this year — on abortion rights.

Michigan has been no exception. A year ago, Michigan Gov. Rick Snyder (R) signed one of the nation’s most extreme anti-abortion laws.

Now lawmakers have used a quirk in Michigan law to push through a bill mandating rape insurance. Yes, you read that right: rape insurance.

ThinkProgress’ Tara Culp-Ressler explains:

On Wednesday evening, both chambers of the Michigan legislature approved a measure that will require women to purchase an additional insurance rider if they want abortion coverage, even in cases when the pregnancy resulted from rape or incest. It will take effect 90 days after lawmakers adjourn, making Michigan the ninth state to restrict coverage of abortion on the private insurance market — an increasingly popular method of imposing barriers to the procedure.

Opponents decried the legislation as a “rape insurance” bill, pointing out that victims of sexual assault would be forced to pay out-of-pocket for an abortion procedure unless they had thought ahead and purchased a separate rider. In the lead-up to the vote, State Senate Minority Leader Gretchen Whitmer (D) called the bill “one of the most misogynistic proposals” that has ever been up for debate in the legislature, adding that forcing women to consider purchasing extra insurance in case they’re raped in the future is “truly despicable.”

And Republicans endorsed the measure even after their own colleagues shared their personal stories of sexual assault and miscarriage. Last year, two female Michigan state representatives were temporarily banned from speaking on the Michigan House floor after they dared speak the word “vagina” during the debate on a different draconian anti-abortion bill.

Snyder had vetoed the bill last year but it will become law this year without his signature because “citizen-initiated” bills (bills advanced following a signature gathering drive) approved by the legislature don’t require his approval. The legislature could have disapproved, in which case the measure would’ve been put before Michigan voters in 2014. Instead, they endorsed the offensive and cruel notion of rape insurance.

Harsh anti-abortion measures like this are just one example of a nationwide campaign by right-wing activists to impose their own theological doctrines onto others using public policy.

BOTTOM LINE: If Republicans don’t want to be accused of waging a war on women, they should stop passing bill after bill that attack women and their families.

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#ACA and Small Business

11/24/2013 Nativegrl77

1st Posted ~~ July 2013

AFFORDABLE CARE ACT: KEY SMALL BUSINESS PROVISIONS

The Affordable Care Act (ACA) will help small businesses by lowering premium cost growth and increasing access to quality, affordable health insurance. If you’re a small employer, the following are some of the ACA provisions that may apply.

Provisions Currently in Effect

Small Business Tax Credits

The small business tax credit helps small businesses afford the cost of health care coverage for their employees and is specifically targeted for those businesses with low- and moderate-income workers. The credit is designed to encourage small employers to offer health insurance coverage for the first time or maintain coverage they already have. Businesses that have fewer than 25 full-time equivalent employees, pay average annual wages below $50,000, and contribute 50% or more toward employees’ self-only health insurance premiums may qualify for a small business tax credit of up to 35% to help offset the costs of insurance. In 2014, this tax credit goes up to 50% and is available to qualified small businesses who participate in the Small Business Health Options Program (SHOP), described below. Eligible small employers can claim the current credit through 2013, and the enhanced credit can be claimed for any two consecutive taxable years beginning in 2014 through the SHOP.

Summary of Benefits and Coverage (SBCs) Disclosure Rules

Employers are required to provide employees with a standard Summary of Benefits and Coverage form explaining what their plan covers and what it costs. The purpose of the SBC form is to help employees better understand and evaluate their health insurance options. Penalties may be imposed for non-compliance. The Department of Labor has provided a sample completed SBC that employers may reference.

Medical Loss Ratio Rebates

Under ACA, insurance companies must spend at least 80% of premium dollars on medical care rather than administrative costs. Insurers who do not meet this ratio are required to provide rebates to their policyholders, which is typically an employer who provides a group health plan. Employers who receive these premium rebates must determine whether the rebates constitute plan assets. If treated as a plan asset, employers have discretion to determine a reasonable and fair allocation of the rebate. For more information on the federal tax treatment of Medical Loss Ratio rebates, refer to IRS’s FAQs.

W-2 Reporting of Aggregate Health Care Costs

Beginning January 2013 (applicable to 2012 reporting), most employers must report the aggregate annual cost of employer-provided coverage for each employee on the Form W-2. The new W-2 reporting requirement is informational only and it does not require taxation on any health plan coverage. Reporting is required for most employer-sponsored health coverage, including group medical coverage.

Small Employer Exception: For 2012 reporting and beyond until further guidance is issued, the W-2 reporting requirement does not apply to employers required to file fewer than 250 Form W-2s in the prior calendar year. To learn more about the requirements, as well as exclusions, visit IRS.gov.

Limits on Flexible Spending Account Contributions

Beginning January 2013, the maximum amount an employee may elect to contribute to health care flexible spending arrangements (FSAs) for any year will be capped at $2500, subject to cost-of-living adjustments. Note that the limit only applies to elective employee contributions and does not extend to employer contributions. To learn more about FSA Contributions, as well as what is excluded from the cap, visit IRS.gov.

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Additional Medicare Withholding on Wages

Beginning January 1, 2013, ACA increases the employee portion of the Medicare Part A Hospital Insurance (HI) withholdings by .9% (from 1.45% to 2.35%) on employees with incomes of over $200,000 for single filers and $250,000 for married joint filers. It is the employer’s obligation to withhold this additional tax, which applies only to wages in excess of these thresholds. The employer portion of the tax will remain unchanged at 1.45%.

New Medicare Assessment on Net Investment Income

Beginning January 1, 2013, a 3.8% tax will be assessed on net investment income such as taxable capital gains, dividends, rents, royalties, and interest for taxpayers with Modified Adjusted Gross Income (MAGI) over $200,000 for single filers and $250,000 for married joint filers. Common types of income that are not investment income are wages, unemployment compensation, operating income from a non-passive business, Social Security Benefits, alimony, tax-exempt interest, and self-employment income.

Employer Notification of the New Health Insurance Marketplace

Beginning January 1, 2014, consumers, self-employed, and small businesses will have access to affordable coverage through the new health insurance Marketplace. No later than October 1, 2013, employers covered by the Fair Labor Standards Act (generally, those firms that have at least one employee and at least $500,000 in annual dollar volume of business), must provide notification to their employees of coverage options available through the Marketplace. Employers are required to provide this notice to all current employees, and to each new employee beginning October 1, 2013, regardless of plan enrollment status (if applicable) or of part-time or full-time status. Separate notice is not required for dependents or other individuals who are or may become eligible for coverage under the plan but who are not employees. The Department of Labor has provided employers with two sample notices they may use to comply with this rule, one for employers who do not offer a health plan and another for employers who offer a health plan for some or all employees. Refer to DOL’s Technical Guidance for more information.

Upcoming Provisions in 2014

Small Business Health Options Program (SHOP) and Individual Marketplaces

Coverage through the competitive health insurance marketplaces for individuals and small businesses will be in place January 1, 2014, with open enrollment beginning October 1, 2013. The Marketplaces will offer four levels of benefit packages that differ by the percentage of costs the health plan covers. Individuals and the self-employed may qualify for individual tax credits and subsidies on a sliding scale, based on income, through the Marketplaces.

Small businesses with generally 50 or fewer employees will have access to Marketplaces through the Small Business Health Options Program (SHOP). Currently, small businesses may pay on average 18% more than big businesses for health insurance because of administrative costs. SHOP will offer small businesses increased purchasing power to obtain a better choice of high-quality coverage at a lower cost. SHOP will also pool risks for small groups and reduce administrative complexity, thereby reducing costs. In 2016, employers with up to 100 employees will be able to participate in SHOP. Businesses can enroll starting on October 1, 2013 through their brokers or directly through the SHOP. Stay connected to the latest information on the Marketplaces by going to signup.healthcare.gov.

90-Day Maximum Waiting Period

Beginning January 1, 2014, individuals who are eligible for health coverage will not have to wait more than 90 days to begin coverage. HHS, IRS, and the Department of Labor have issued proposed rules on how employers should apply the 90-day rule.

Workplace Wellness Programs

The Affordable Care Act creates new incentives to promote employer wellness programs and encourage employers to take more opportunities to support healthier workplaces. Health-contingent wellness programs generally require individuals to meet a specific standard related to their health to obtain a reward, such as programs that

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provide a reward to employees who don’t use, or decrease their use of, tobacco, and programs that reward employees who achieve a specified level or lower cholesterol. Under final rules that take effect on January 1, 2014, the maximum reward to employers using a health-contingent wellness program will increase from 20 percent to 30 percent of the cost of health coverage. Additionally, the maximum reward for programs designed to prevent or reduce tobacco use will be as much as 50 percent. The final rules also allow for flexibility in the types of wellness programs employers can offer. For more information and to view the final rules, visit http://www.dol.gov/ebsa.

Upcoming Provisions in 2015

Employer Shared Responsibility Provisions

Beginning in 2015, employers with 50 or more full-time (or full-time equivalent) employees that do not offer affordable health insurance that provides minimum value to their full-time employees (and dependents) may be required to pay an assessment if at least one of their full-time employees is certified to receive a premium tax credit to purchase coverage in an individual Marketplace. A full-time employee is one who is employed an average of at least 30 hours per week. If a business meets the threshold level of 50 full-time or full-time equivalent employees, or is close to it, it’s important to understand how these rules may apply and how the payment amounts could be calculated. Refer to this FAQ from the IRS for more information.

Note: On July 2, 2013, Treasury issued transitional relief to employers covered by these rules indicating that no shared responsibility payments will apply until 2015. Further guidance is expected to be issued shortly.

Businesses with fewer than 50 employees are generally not affected by the Employer Shared Responsibility rules – that is nearly

96 percent of all firms in the United States. These smaller employers do not have to pay an assessment if their full-time employees receive premium tax credits to purchase coverage in one of the new Marketplaces.

Health Insurance Coverage Reporting Requirements

Beginning in 2015, employers subject to the Employer Shared Responsibility rules must provide the IRS with information about full time employees’ coverage under the health plans and the cost of benefits provided. Likewise, employers that sponsor self-insured plans must submit reports detailing information for each covered individual. Treasury is expected to publish Proposed Rules this summer that provide further guidance about these provisions.

ADDITIONAL RESOURCES

The U.S. Small Business Administration’s health care web page, http://www.sba.gov/healthcare, is dedicated to educating small business owners about the Affordable Care Act. This site serves as a gateway for small business owners, connecting them with information provided by SBA’s federal partners responsible for implementing the law, including the U.S. Department of Health and Human Services (HHS).

Healthcare.gov is a web portal maintained by HHS. The small business tab includes information about the new health insurance Marketplaces, coverage options, and more. Businesses can stay connected to the latest information on the Marketplaces by signing up for text and email alerts at signup.healthcare.gov.

For a Glossary of key terms under the Affordable Care Act, click here.

IRS website includes summaries of tax-related ACA provisions, FAQs, and eligibility worksheets.

Employers can also refer to the Department of Labor’s website for ACA-related information at http://www.dol.gov/ebsa/healthreform.

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4.8 Million Denied Coverage

11/21/2013 Nativegrl77

By CAP Action War Room

The Republican Coverage Gap

The frenzy of attention surrounding insurance companies dropping substandard policies peaked last week when the House of Representatives voted on the GOP’s 46th attempt to repeal Obamacare.

Republicans, however, don’t seem to much care about the nearly 5 MILLION poor Americans who won’t receive any coverage at all because Republican governors and state legislators in 25 states are refusing to expand Medicaid. Indeed, the very same politicians and conservative groups expressing the most outrage about insurers dropping substandard insurance plans are also actively campaigning against the Medicaid expansion.

This means that families making just a few thousand dollars a year are still not considered poor enough to qualify for Medicaid in Texas and many other states refusing to expand eligibility.

Here’s a ThinkProgress infographic showing how those being denied coverage by Republicans for political reasons compares to those who have received cancellation notices.

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You can find out more on the coverage gap HERE.

BOTTOM LINE: The number of Americans who Republicans want to gain coverage under Obamacare is ZERO, which they’ve demonstrated by voting almost 50 times to repeal the law. While Democrats want to make Obamacare work, Republicans only want it to go away and are working to deny millions of the neediest Americans health coverage in the meantime.

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A Trojan Horse

11/18/2013 Nativegrl77

By CAP Action War Room

Who Is Really Trying to ‘Fix’ Obamacare?

President Obama, Congressional Democrats, and House Republicans all have proposed changes to Affordable Care Act to address concerns over dropped policies, but not all of these so-called fixes are created equal.

While the Democratic plans seek changes to actually address the concerns, the Republican plan passed by the House of Representatives today is actually a Trojan Horse meant to destroy Obamacare and put insurance companies back in charge once and for all. In fact, Speaker Boehner (R-OH) explained that it was a “targeted strike” on the law and just one more step on the road to repeal.

(The road to repeal seems to be neverending, as the House has now voted at least 46 times to repeal Obamacare and yet it’s still the law of the land.)

House Republicans further betrayed their true motivations today when they used procedural tricks to block a vote on a Democratic plan to allow insurers to keep offering cancelled plans, expand oversight of rate hikes, and require insurers to notify consumers of alternatives to their sub-standard plans.

The GOP’s reason for blocking a vote on the bill? They said it had too manyprovisions protecting consumers from insurance companies and abusive rate hikes.Seriously.

Here’s a chart breaking down the differences between the main proposals out there to address concerns about insurers dropping sub-standard insurance plans: