Tag: health care

Patients’ Perilous Months-Long Waiting for Medicaid Coverage Is a Sign of What’s to Come

Korra Elliott has tried to avoid seeing a doctor while waiting to get on Medicaid. She worries she can’t afford more bills without any insurance coverage. But in early March — five months, she said, after applying and with still no decision about her application — a suspected case of the flu sent her blood pressure soaring and landed her in the emergency room.

The 28-year-old mother of four from Salem, Missouri, is among the tens of thousands of uninsured Missourians stuck waiting as the state slogs through a flood of applications for the state-federal health insurance program. Missouri expanded the program last year after a lengthy legal and political battle, and it now covers adults who earn up to 138% of the federal poverty level — about $18,800 annually for an individual.

Missouri had nearly 72,000 pending Medicaid applications at the end of February and was averaging 119 days to process one, more than twice the maximum turnaround time of 45 days allowed by federal rules. Adding people to Medicaid is labor-intensive, and the jobs require training and expertise. The program covers many populations — children, people with disabilities, seniors, adults who are pregnant or have children, and some without children. Different rules dictate who qualifies.

Read the full article from KHN.

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Desperate for Cash: Programs for People With Disabilities Still Not Seeing Federal Funds

LILBURN, Ga. — Matthew Southern, 35, who has intellectual and developmental disabilities, is able to stay out of an institution because health aides paid through a Medicaid program assist him and his roommate with ordinary tasks.

But amid a worker shortage worsened by the pandemic, Southern’s father, Dan, has had to step in to fill in gaps in his son’s care by volunteering at their home 45 minutes away from his northwestern Atlanta suburb. He blames the low pay across the industry.

“No one wants to work for $12 an hour,” Dan Southern said. “People can work at Burger King and make more money.”

Last year brought an injection of hope: The federal government, through the American Rescue Plan Act that President Joe Biden signed into law in March 2021, increased funding with a 10-percentage point match that could amount to some $25 billion in federal money for Medicaid home and community-based services, which have long faced staffing crunches. That massive infusion of cash could be used by states to buttress wages, move people off waiting lists for disability services, train more workers, or expand covered services for vulnerable elderly and disabled people, helping to keep them out of nursing homes.

But almost a year later, Indiana, Massachusetts, New York, North Carolina, Ohio, and Washington were among 19 states as of Feb. 17 yet to receive the “conditional approval” needed from the Centers for Medicare & Medicaid Services to fully access the money.

Read the full article from KHN.

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Mental Health Therapists Seek Exemption From Part of Law to Ban Surprise Billing

Groups representing a range of mental health therapists say a new law that protects people from surprise medical bills puts providers in an ethical bind and could discourage some patients from care.

The therapists take no issue with the main aim of the legislation, which is to prevent patients from being blindsided by bills, usually for treatment received from out-of-network medical providers who work at in-network facilities. Instead, they are concerned about another part of the law — a price transparency provision — that requires most licensed medical practitioners to give patients detailed upfront cost estimates, including a diagnosis, and information about the length and costs involved in a typical course of treatment. That’s unfitting for mental health care, they say, because diagnoses can take time and sometimes change over the course of treatment.

Read the full article at KHN.

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Universal Health Care Commission to Hold its First Meeting Next Week

On Tuesday, November 30, the Universal Health Care Commission (UHCC) will meet on Zoom. During their first meeting, UHCC members will receive:

  • An orientation to the legislation and commission purpose
  • Open Public Meetings training
  • A review of the draft charter and operating procedures

Meeting details

Tuesday, November 30, 2021
1-3 p.m.
Meet on Zoom (no registration required)

Live captioning may be available: Communication Access Real-time Transcription (CART) services, or live closed captioning, may be available for this event, on demand. To request this accommodation, please submit a request to rachelle.alongi@hca.wa.gov as soon as possible. We will make every effort to accommodate this request but cannot guarantee that a CART writer will be available.

What’s the UHCC?

Washington State seeks to establish a universal health care system for all residents, where people have access to affordable, high-quality health care. Senate Bill 5399 passed during the 2021 legislative session, creating a Universal Health Care Commission to aid in this effort.

View our commission roster.

Can I provide public comment or testimony?

Yes. Your input is a crucial part of the UHCC process. Every commission meeting will have a designated time for public comment. If you would like to let us know in advance you’ll be speaking, please contact us at HCA_UniversalHCC@hca.wa.gov. You can also submit comments in writing at any time.

Where can I get more information?

Sign up to receive announcements about the UHCC.

Enrollment Period for Marketplace Coverage Starts

“In accordance with the Executive Order signed by President Biden, the Centers for Medicare & Medicaid Services (CMS) is announcing that the Special Enrollment Period (SEP) for the Health Insurance Marketplace® will officially be available to consumers in the 36 states that use the HealthCare.gov platform on Monday, February 15, and will continue through Saturday, May 15. At least 13 States plus the District of Columbia, which operate their own Marketplace platforms, have decided to offer a similar opportunity.

“President Biden was clear: we need to strengthen the Affordable Care Act and give more Americans access to health care, especially during this pandemic, which has further demonstrated the importance of having the right coverage. This Special Enrollment Period will give Americans who need affordable, quality health insurance an opportunity to get covered, and we encourage folks to head to HealthCare.gov starting on Monday to explore their options,” said HHS Acting Secretary Norris Cochran.”

Read the full announcement from HHS.

Washington Healthplanfinder Sees Surge in Customers as Final 2021 Deadline Approaches

OLYMPIA, Wash. – People statewide flocked to Washington Healthplanfinder this week to beat the Dec. 15 deadline for health coverage that would start the first of the year. With that date now passed, Washingtonians still seeking 2021 health coverage have until Jan 15, 2021 to shop on Washington Healthplanfinder for coverage that begins February 1.

“We were glad to see the large number of enrollees come in and secure coverage that starts Jan. 1,” said Chief Executive Officer Pam MacEwan. “This year, in response to the public health emergency, we are providing additional time for those who didn’t enroll prior to Dec. 15 to sign up for 2021 coverage over the next month.”

As of Dec. 16, about 210,000 Washingtonians have signed up for 2021 coverage, including almost 30,000 new customers. Among new customers, 41% have selected a Cascade Care plan. Cascade Care plans cover more services prior to meeting a deductible, including primary care visits, mental health services, and generic drugs. Customers who need to renew their plan for 2021 can sign in to their Washington Healthplanfinder account using the WaPlanfinder Mobile App or on WAHealthplanfinder.org and easily update and renew their coverage. Additionally, some customers may find that they qualify for free or low-cost coverage.

Washington Healthplanfinder offers a wide range of resources to help people navigate their coverage options – including in-person enrollment centers, virtual video or phone assistance, and the WAPlanfinder Mobile App. Anyone requiring help signing up for coverage through Washington Healthplanfinder may contact the Customer Support Center at 1-855-923-4633; TTY: 855-627-9604. They may also contact an Exchange certified Navigator, Broker, or Enrollment center who can answer insurance questions and help with enrollment. Free help from local experts is accessible via the WAPlanfinder Mobile App or by visiting www.wahealthplanfinder.org.

During the 2021 open enrollment period, the Customer Support Center is open 7:30 a.m. – 8:00 p.m. Monday – Friday. Additionally, extended hours scheduled:

December
• Thursday, December 24, 7:30 a.m. – 3:00 p.m.
• Thursday, December 31, 7:30 a.m. – 3:00 p.m.

January
• Saturday, January 9, 10:00 a.m. – 2:30 p.m.
• Thursday, January 14, 7:30 a.m. – 11:59 p.m.
• Friday, January 15, 7:30 a.m. – 11: 59 p.m.

Reminders: Enrollment is offered year-round on Washington Healthplanfinder to individuals and families through Washington Apple Health (Medicaid).

About Washington Healthplanfinder
Washington Healthplanfinder is an online marketplace for individuals and families in Washington to compare and enroll in health insurance coverage and gain access to tax credits, reduced cost sharing and public programs such as Medicaid. The next qualified health and dental plans open enrollment period for Washington Healthplanfinder from Nov. 1, 2020 to Jan. 15, 2021.

Income-Related Inequalities in Affordability and Access to Primary Care in Eleven High-Income Countries

As COVID-19 continues to ravage the globe, the United States faces renewed scrutiny for the stark disparities in health and economic impacts experienced by people with lower incomes and by Black and Latino communities. In other countries, the crisis has highlighted the need for greater resiliency of national health systems to ensure access to care.

To compare the health experiences of adults with lower income during the pandemic and the effect of income-related disparities, the Commonwealth Fund surveyed adults across 11 high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the U.S. The results of the survey, conducted during the early part of the pandemic between February and May 2020, were published in the December 2020 issue of Health Affairs.

What the Study Found

  • In nearly all countries, adults with lower income were significantly more likely than those with higher income to have multiple chronic health conditions. However, on nearly every measure the study used, income-related disparities were greatest in the U.S.:
    • More than one-third (36%) of U.S. adults with lower income have two or more chronic conditions — significantly more than in other countries.
    • Approximately one-third of adults with lower income in the U.S. (36%), Australia (36%), and Canada (34%) reported having anxiety or depression, the highest rates in the survey. Their counterparts in Germany (14%) and Switzerland (15%) were the least likely to report anxiety or depression.
    • More than one-quarter (28%) of U.S. adults with lower income said that, in the past year, they worried about being able to afford basic necessities such as food or housing, a significantly greater proportion than seen in other countries, where 6 percent to 22 percent reported this.
  • Half of U.S. adults with lower income don’t get needed care because it’s too costly. In the survey, 50 percent reported skipping doctor visits, recommended tests, treatments or follow-up care, or prescription medications in the past year because of the cost. In contrast, just 12 percent to 15 percent of adults with lower income in Germany, the U.K., Norway, and France reported doing the same.

Read the full article from the Commonwealth Fund