Women's Health Coverage -How ACA Repeal Will Affect You !

AFFORDABLE CARE ACT REPEAL THREATENS THE HEALTH AND ECONOMIC SECURITY OF 7.8 MILLION WOMEN WHO RECENTLY GAINED INSURANCE COVERAGE

Health care is key to women’s well-being and economic stability. Thanks to the Affordable Care Act (ACA, also known as “Obamacare”), insurance is easier to get and afford, and plans can no longer refuse to cover women. Each year, millions of women enroll in insurance plans under the ACA, but the law is under constant threat. Any repeal of the ACA or changes to the Medicaid program threaten the important gains women have made in obtaining quality, affordable health coverage that allows them to stay healthy and economically secure. Recent Census data show that if the ACA is repealed or changes are made to the Medicaid program, women have a lot to lose. LOSING GAINS IN HEALTH COVERAGE NATIONWIDE: • More than 88.5 million women ages 18–64 across the United States now have health insurance through an employer, the ACA marketplaces, state Medicaid programs, or another source. This means almost 9 in 10 women ages 18–64 now have health coverage. • Between 2013–2015, more than 7.8 million women ages 18–64 gained health insurance coverage, a growth rate of 10 percent nationally.1 Repealing the ACA or changing the Medicaid program puts these millions of women in jeopardy of losing their health coverage. REVERSING GAINS IN EVERY STATE: • Five states and D.C. have achieved nearly universal health coverage (95 percent or greater) of women ages 18–64, and in the majority of states, more than 90 percent of non-elderly women now have health insurance coverage. Before the ACA, only one state (Massachusetts) had nearly universal coverage of women ages 18–64. • The ten states with the greatest increase in health coverage between 2013–2015 for women ages 18–64 are Nevada, California, Kentucky, Florida, Oregon, Arkansas, West Virginia, Washington, Arizona, and Texas, where more than half of the 7.8 million women ages 18–64 who gained health coverage reside. ACA repeal or changes to the Medicaid program could mean women lose the health coverage they have gained in every state across the country. SPECIFICALLY THREATENING GAINS IN STATES THAT HAVE EXPANDED MEDICAID: • States expanding Medicaid have seen the largest increases in insurance coverage of women ages 18–64 between 2013–2015. The vast majority—about 5 million—of women ages 18–64 who have gained health coverage live in a state that expanded Medicaid. • Non-expansion states have the lowest proportions of women ages 18–64 with health coverage. The states with the lowest are Mississippi, Florida, Oklahoma, Georgia, and Texas. In Texas, more than 1 in 5women ages 18–64 remains uninsured. These data indicate that expanding Medicaid produces large gains in health insurance for women across the board. Repealing the ACA, and in particular repealing Medicaid expansion, would put these gains at risk. 11 DUPONT CIRCLE, NW, #800, WASHINGTON, DC 20036 P: (202) 588 5180 WWW.NWLC.ORG HEALTH | PAGE 2 Find information on the gains made in coverage for women ages 18–64 in your state, and how many women stand to lose coverage, below. Health Insurance Coverage of Women 18-64 Source: NWLC calculations based on American Community Survey (IPUMS-USA), 2013 and 2015 ACS 1-year estimates available at https://usa.ipums.org/usa/index.shtml. 1 NWLC calculations based on American Community Survey (IPUMS-USA), 2013 and 2015 ACS 1-year estimates available at https://usa.ipums. org/usa/index.shtml. Gains made in health insurance coverage of women 18–64, from 2013–2015 is calculated as the difference between the number of women with health insurance in 2013 and number of women with health insurance in 2015. Our analysis compares 2013 and 2015 health insurance coverage of women 18-64 as a representation of pre- and post-Affordable Care Act (ACA) trends. While some reforms of the ACA went into effect in 2010, the marketplaces did not become operational until 2014, and many of the major reforms aimed at expanding health coverage to more Americans—such as prohibitions on denying coverage for prior medical conditions, requirements that individuals have health insurance coverage, expansion of Medicaid to all adults making up to 133% of Federal Poverty Level, and availability of tax credits.

Pre-existing conditions: How 130 million Americans maybe affected by the Obamacare Repeal

The U.S. House of Representatives passed by a 217-213 margin on Thursday a revised version of the American Health Care Act -- a bill that rolls back federal protections for those with pre-existing conditions and sets the stage for loss of coverage for some 24 million Americans. If signed into law, this could mean health care cost increases for an estimated 130 million Americans.

In the pre-Obamacare era, insurers were able to deny coverage outright to people with pre-existing conditions. The Affordable Care Act banned individual states from allowing insurers to charge people with pre-existing conditions at a higher cost.

Under the American Health Care Act, states can opt to allow individual insurers the discretion of deciding what does and not count as a pre-existing condition. While people with those pre-existing condition can't be denied coverage, they can potentially be charged more. These states would also receive $138 billion over a 10-year period to help subsidize.

The idea behind this provision is that it would make health insurance cheaper for people who are relatively healthy, while sick people would be in their own, subsidized risk pool. As they debated on the House floor Thursday, Republican members consistently assured their audience that their bill would still protect preexisting conditions."

Varying policy perspectives abound, but the greatest fear for opponents of the legislation is that the $138 billion fund to set up a "high-risk pool" simply won't be enough.

While individual insurers have the right to choose what is defined as a "pre-existing condition," these are the conditions that were previously listed as deniable in the market, before the ACA was passed:

- AIDS

- HIV

- Lupus

- Alcohol abuse

- Drug abuse with recent treatment

- Mental disorders (severe, e.g. bipolar, eating disorder)

- Alzheimer's/dementiaMultiple sclerosis

- Arthritis (rheumatoid), fibromyalgia, other inflammatory joint disease

- Muscular dystrophy

- Cancer within some period of time (e.g. 10 years, often other than basal skin cancer)

- Obesity, severe

- Cerebral palsy

- Organ transplant

- Congestive heart failure

- Paraplegia

- Coronary artery/heart disease, bypass surgery

- Paralysis

- Crohn's disease/ ulcerative colitis

- Parkinson's disease

- Chronic obstructive pulmonary disease (COPD)/emphysema

- Pending surgery or hospitalization

- Diabetes mellitusPneumocystic pneumonia

- Epilepsy

- Pregnancy or expectant parent

- Hemophilia

- Sleep apnea

- Hepatitis (Hep C)

- Stroke

- Kidney disease, renal failure

ObamaCare Medicaid Expansion

ObamaCare Expansion Enrollment is Shattering Projections

Medicaid expansion already makes welfare for able-bodied adults a higher priority than services for the nearly 600,000 seniors, children with developmental disabilities, individuals with brain injuries, and other vulnerable individuals currently languishing on waiting lists for needed Medicaid services. Mounting overruns will soon exacerbate pressure on policymakers to shift even more money away from the truly needy and towards ObamaCare’s able-bodied adults.

Medicaid Espansion & what it means for you!

While nearly 600,000 truly needy individuals with disabilities are trapped on Medicaid waiting lists, ObamaCare’s Medicaid Expansion redirects limited taxpayer resources to a new welfare class of able-bodied, childless adults that puts them at risk. An FGA study found that every ObamaCare expansion state with available data has enrolled more able-bodied adults than they expected to ever enroll. On average, these states have enrolled 110% more adults than expected.

State spending on Medicaid increased 71% in the last 10 years, making it one of the largest and fastest growing line items in state budgets. Because it is growing faster than state revenues, the program siphons away resources from other budget priorities, like kids, cops, and roads. Medicaid expansion throws gas on this spending fire.

Resources

•  ObamaCare’s Medicaid Expansion
•  Medicaid Expansion FAQs
•  Hospitals and ObamaCare’s Medicaid Expansion FAQs
•  ObamaCare Expansion Enrollment is Shattering Projections
•  Work Requirements Work Well for Welfare
•  Traditional Medicaid vs ObamaCare’s Medicaid Expansion
•  Obamacare’s Medicaid Enrollment Explosion: A Looming Fiscal Nightmare For States
•  How the New Congress Can Thoughtfully Repeal ObamaCare’s Expansion

ObamaCare Expansion Enr

Choices grow thin as premiums soar & Donald Trump tweets

Article by Tom Murphy, ABC News 04/26/2017

One health insurer is eager to dive back into the Affordable Care Act's troubled insurance exchanges next year, even as competitors waver and President Donald Trump tweets doom about the law's future.

Centene Corp. said Tuesday that its exchange enrollment has swelled 74 percent since last year, up to nearly 1.2 million people.

This comes as competitors like Aetna back away from these public marketplaces after absorbing steep losses, and others like the Blue Cross-Blue Shield carrier Anthem await signs of stability before committing to 2018. Trump has warned repeatedly about the collapse of the law and its exchanges, which provide coverage for around 12 million people.

Insurers have struggled to build a stable business out of the exchanges, in part because they can't attract enough young, healthy people to balance out sicker customers who use their coverage. Soaring premiums haven't helped that push. Companies also say they've been stung by expensive patients who wait until they need the coverage before enrolling.

As a result, exchange choices have grown thin, with many markets down to a single insurer. Some in Tennessee have none.

Heading into 2018, insurers also are nervous about the future of billions of dollars in cost-sharing assistance for some exchange customers with modest incomes.

Despite all this, Centene Chairman and CEO Michael Neidorff said Tuesday during a conference call to discuss the company's first-quarter results that he sees "nothing out there" that will change his company's participation next year.

"We have the agility and the ability to adjust," he said.

Centene sells coverage under its Ambetter brand on exchanges in 12 states. That includes key markets like Florida, Texas and Ohio.

What makes it more bullish than its competitors on these still unstable markets? Analysts say Centene sticks to customers it knows. The insurer specializes in managing the state and federally funded Medicaid program for the poor. On the exchanges, it targets low-income customers in markets where it has already formed networks of providers for its Medicaid business.

That means the insurer doesn't have to build doctor networks for its exchange business from scratch. It also means Centene generally serves customers who get big subsidies that can shield them from price hikes. This makes it more likely they keep their coverage.

Neidorff said Tuesday that 80 percent of Centene's 2016 exchange customers renewed their plans in 2017. Repeat business like that makes it easier for insurers to figure out prices.

Centene has added some new exchange business through its acquisition of fellow insurer Health Net, said Stifel health insurance analyst Thomas Carroll.

It also has gained customers as competitors like UnitedHealth Group Inc. and Humana Inc. have left markets, noted Ana Gupte, who follows insurers as a senior analyst with Leerink Partners.

St. Louis-based Centene Corp. didn't detail financial results from its exchange business. But the insurer said Tuesday it earned $139 million overall in a first-quarter performance that topped Wall Street expectations.

Insurers are still sorting out their coverage plans for next year, so others may still come forward with their own exchange testimonials. They have until late spring or early summer, depending on the state, to make an initial decision on where they plan to sell next year.

Another big exchange participant, Indianapolis-based Anthem Inc., will report Wednesday on its first quarter.

Jefferies analyst David Windley said late last month in a research note that he thought the Blue Cross-Blue Shield insurer was leaning toward leaving a "high percentage" of the exchange markets in which it participates.

An Anthem spokeswoman said in response that the insurer was still pursuing "policy changes that will help with market stabilization and achieve the common goal of making quality health care more affordable and accessible for all."

An Anthem pullback would be a huge blow to the exchanges. Heading into 2017 Anthem was the lone insurer on exchanges in 300 counties in seven states, according to data compiled by The Associated Press and the health research firm Avalere.

Anthem to likely exit ACA for 2018

News of the Jefferies' analysis first was reported by Bloomberg.

Anthem currently insures more than 800,000 individual plan customers in 144 rating regions in 14 states.

Other major insurers, including Aetna, UnitedHealthcare, Cigna and Humana, have already scaled back their footprints in the Obamacare markets.

But Anthem's exit would potentially have a bigger impact.

Earlier this month, an analysis by Axios.com said, "An Anthem exit would cause arguably the most disruption nationwide."

"Roughly 255,000 people across Colorado, Kentucky, Missouri and Ohio would have no Obamacare insurers for 2018, and 560,000 people in eight states would have just one insurer," the analysis by Axios.com said.

Anthem's management has indicated that it would like regulatory changes that could lower the financial risk it runs in insuring Obamacare customers.

The Jefferies report said that management told the analysts that "regulatory advocacy needs to progress significantly in the next 'month or so.' "

"Improvements such as eligibility verification, more rigid special enrollment periods, shortening of premium grace periods are steps in the right direction, but not enough," the Jefferies analysts wrote of Anthem's view.

Another factor that would play into Anthem's decision on whether, and to what extent, to pull out of Obamacare markets is the level of health claims that its current pool of customers will end up having this year.

Management told Jefferies that it normally takes up to six months of claims "to get a sense of risk profile on its new enrollees (so, mid-year)."

2016 Tax Information Form 1095 A Colorado

2016 Tax Information

As tax season approaches, all tax filers must report whether or not they had health insurance coverage on their 2016 tax returns. The Affordable Care Act requires that most individuals have health coverage that meets certain minimum standards and uses the tax system to enforce that requirement. Depending on how you received your health insurance coverage, you will receive certain forms to help assist with your taxes and confirm that you met the requirement by law to have health insurance.

If you bought health insurance coverage through Connect for Health Colorado in 2016, you will receive a Form 1095-A (Health Insurance Marketplace Statement). If you need a corrected form by the tax deadline, April 18, please call 855-PLANS-4-YOU (855-752-6749) no later than March 10, 2017 to request a corrected form. All of your Form 1095-As, current and past years, are also available in the “My Documents” section of your online account.

If you are concerned about completing your tax return by the April 18 deadline, you may want to look into obtaining a tax extension by talking with your tax preparer, going to IRS.GOV or reviewing instructions contained in your tax filing software. If you have already filed your taxes, you may wish to look to those same resources for information on how to file an amended return.

Why is Form 1095-A important: The information on Form 1095-A will help you report your health insurance coverage and any financial assistance you may have received last year to the IRS. Be sure to keep the document in a safe spot you can easily access when you file your 2016 taxes. If you received financial assistance, it was either in the form of an Advance Premium Tax Credit, or you may have opted to file for a premium tax credit when you complete your 2016 income tax return.

We provide Form 1095-A to the head of household for each plan in which individual(s) in the household are enrolled. So you may receive multiple Form 1095-As if you:

• Changed plans in the middle of the year.
• Added or removed members from the policy during the year.
• Have members of your household enrolled in different plans.

If you were enrolled in a catastrophic plan, you are not eligible for a premium tax credit.  Furthermore, if you were enrolled in a catastrophic plan, you will not receive a Form 1095-A from Connect for Health Colorado.  You might receive a Form 1095-B from your health insurance company reflecting your 2016 catastrophic plan coverage.  If you are curious about whether or not you will receive a 1095-B regarding your catastrophic coverage, please contact your health insurance company.