Tag: healthcare

Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead

The Biden administration and state officials are bracing for a great unwinding: millions of people losing their Medicaid benefits when the pandemic health emergency ends. Some might sign up for different insurance. Many others are bound to get lost in the transition.

State Medicaid agencies for months have been preparing for the end of a federal mandate that anyone enrolled in Medicaid cannot lose coverage during the pandemic.

Before the public health crisis, states regularly reviewed whether people still qualified for the safety-net program, based on their income or perhaps their age or disability status. While those routines have been suspended for the past two years, enrollment climbed to record highs. As of July, 76.7 million people, or nearly 1 in 4 Americans, were enrolled, according to the Centers for Medicare & Medicaid Services.

When the public health emergency ends, state Medicaid officials face a huge job of reevaluating each person’s eligibility and connecting with people whose jobs, income, and housing might have been upended in the pandemic. People could lose their coverage if they earn too much or don’t provide the information their state needs to verify their income or residency.

Medicaid provides coverage to a vast population, including seniors, the disabled, pregnant women, children, and adults who are not disabled. However, income limits vary by state and eligibility group. For example, in 2021 a single adult without children in Virginia, a state that expanded Medicaid under the Affordable Care Act, had to earn less than $1,482 a month to qualify. In Texas, which has not expanded its program, adults without children don’t qualify for Medicaid.

State Medicaid agencies often send renewal documents by mail, and in the best of times letters go unreturned or end up at the wrong address. As this tsunami of work approaches, many state and local offices are short-staffed.

Read the full article from KHN.

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Determining the Safety of a Hospital or Medical Provider

Choosing a new hospital or provider is difficult, and safety is often a main concern. While there are several ways to look at safety information surrounding providers and clinics, there is no consensus as to the best approach. Here are some ways to evaluate the safety of your health care.

Medicare penalizes hospitals that have high rates of infections and patient injuries.  The information which hospitals the federal government has penalized (764 hospitals last year) is publicly available and can be viewed on KFN. However, the hospital industry has issues with penalties, saying that it creates an arbitrary cutoff for which institutions get punished and which don’t.

The Leapfrog Group has collected, analyzed, and published hospital data, and their 2021 Leapfrog Hospital Safety Grades include 49 Washington Hospitals.  U.S. News & World Report publishes a “Best Hospitals in Washington” ranking.  However, it does not rate the safety of the hospital, but the health outcomes and specialists that it employs.

Evaluating doctors is more difficult, as negative reviews given by patients cannot be commented upon by the care provider, due to HIPAA regulations. The Washington Department of Health regularly reports on any disciplinary actions against a health care provider on their newsroom page.  On their website, it is also possible to look up a health care provider license to view a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents.

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Resource by Type

Clallam Resources by Type

Applying for Services

Makah Tribe Services – Neah Bay, WA 98357

Includes Women, Infants and Children (WIC) Program, Headstart, Early Childhood Education, Tribal Health, Social Services, Education & Human Services

360-645-3265

Port Angeles Community Services Office – 201 W 1st St., Suite 2, Port Angeles, WA 98362

Includes Community Services Office, Foster and Adoption Services, and the Child Welfare Office.  Can help with emergency food, cash, or medical assistance.

Monday-Friday 8:00-5:00pm

Reception: 877-501-2233; Department of Children, Youth, and Families: 360-405-5822

Also see Lutheran Community Services (Food)

Behavioral Health

Jamestown Family Health Clinic – 808 N 5th Ave, Sequim, WA, 98382

Provides primary medical services to tribal citizens and non-tribal community members.

Monday-Friday 8:00am – 5:00pm and Saturday 10:00am-3:00pm

360-683-5900

Klallam Counselling Services – 243613 Hwy 101 West, Port Angeles, WA  98363

Counseling services and addiction therapy, operated by the Lower Elwha, and catering to both tribal and non-tribal members of the community.

Monday- Friday 8:00am-6:00pm

360-452-4432

Peninsula Behavioral Health – 118 East 8th Street, Port Angeles, WA 98362 and 490 North 5th Avenue, Sequim, WA 98382

Services include counseling, stabilization, psychiatric evaluation, medication management, crisis intervention, WISe (Wraparound with Intensive Services), family therapy, and PATH (Projects for Assistance in Transition from Homelessness.)

Port Angeles Office: 360-457-0431; Crisis Services: 1-800-843-4793

True Star Behavioral Health Services – 1912 West 18th Street, Port Angeles, WA 98363

Offers the following services: Alcohol/Drug Assessments, CDDA Assessments and Treatment Placement, Drug Court, Detention Based Treatment, Outpatient Treatment, DUI Assessments, Mental Health Counseling

360-417-2282

West End Outreach Services – 551 Bogachiel Way, Forks, WA 98331

Offers: Assessments and referrals to help identify treatment needs and options, Outpatient Services: Progressive programs to address the physical and psychological aspects of addiction, Co-Occurring Treatment to assist people who are struggling with addiction and mental illness, and Youth Treatment

Monday, Friday: 8:00am-5:00pm & Tuesday, Wednesday, Thursday: 8:00am–6:00pm

Office: 360-374-5011; Crisis: 800-843-4793

Child Care

Boys & Girls Club of Port Angeles – 2301 S. Francis Street, Port Angeles, WA 98362

The Port Angeles Unit is equipped with a Teen Center, Games Room, Art Room, Technology Center, Education Room, Snack Area and an Outside Play area. The Unit serves 90+ youth per day.

Monday-Friday: 1:30pm-6:00pm (academic year) & 12:00pm-6:00pm (summer)

360-417-2831

Boys & Girls Club of Sequim – 400 West Fir Street, Sequim, WA 98382

Facilities for children include a games room, library, art room, computer lab, a gym, and programs dedicated to building academic success and good character and citizenship as well as healthy lifestyles.

Monday-Friday: 2:00pm-6:00pm (academic year) & 12:00pm-6:00pm (summer)

360-683-8095

Boys & Girls Club of Sequim – 400 West Fir Street, Sequim, WA 98382

Facilities for children include a games room, library, art room, computer lab, a gym, and programs dedicated to building academic success and good character and citizenship as well as healthy lifestyles.

Monday-Friday: 2:00pm-6:00pm (academic year) & 12:00pm-6:00pm (summer)

360-683-8095

Concerned Citizens – 945 S Forks Ave, Forks, WA, 98331

Offers employment services, at home care services, and runs the Sunshine and Rainbows Child Development Center.

Forks 360-374-9340; Port Angeles 360-452-2396

First Steps Family Support Center – 325 E. 6th Street, Port Angeles, WA

Offers free clothing and equipment closet, information and referrals, a children’s play area, emergency diapers and formula, parenting classes, Play & Learn classes, and at-home resources.

Drop-In Center Monday-Thursday 1:00pm-4:00pm

360-457-8355

Forks Early Childhood Education and Assistance Program – at Forks Elementary School, 301 S. Elderberry Ave., Forks, WA 98331

ECEAP (Early Childhood Education and Assistance Program) is Washington’s pre-kindergarten program that prepares 3- and 4-year-old children from low-income families for success in school and in life.

360-374-6262 Ext 472

Mount Angeles View Head Start/Early Head Start  – 2321 S Francis St, Port Angeles, WA 98362

Head Start helps with children aged 3-7 years; Early Head Start helps with children aged 12 months to 3 years.

Open every day 8:00am-3:30pm

360-452-8496 or 360-775-2359

Port Angeles Head Start – 2203 W. 18TH St., Port Angeles, WA 98363

Child care for those aged 3-6 years old

360-775-2409

Queets Head Start Center – 402 Jackson Heights Dr, Forks WA

Serves the Quinault Indian Nation

360-962-2051

Sequim Head Start – 224 N. Sequim Avenue, Sequim, WA 98382

Child care center helps with children in the age range of 3 years to 7 years

Open Every day 8:30am-2:30 pm

360-582-3709

Sunshine and Rainbows Child Development Center – 945 S Forks Ave, Forks, WA 98331

Staff are qualified to provide services in Behavior Management, Developmental Therapy, Early Childhood and are trained to provide a preschool like environment all day long.

Monday-Friday: 6:30am-5:30pm

360-374-9340

Also see YMCA (Youth Services)

Clothing

First United Methodist Church of Port Angeles – 110 East Seventh Street, Port Angeles, WA

Clothes closet, Friday dinners, and emergency services.  Call the Church office for more information.

360-452-8971

Also see First Steps (Child Care)

Domestic Abuse Support

Healthy Families of Clallam County – 1210 E Front Street Suite C, Port Angeles, WA 98362 and 272 West Bell Street, Sequim, WA 98382

HFCC provides domestic violence, sexual assault and child abuse prevention and treatment services free of charge to adult survivors, child victims, families of victims, and the community.

Emergency: 360-452-4357; Port Angeles: 360-452-3811; Sequim: 360-452-3811

Lower Elwha Family Advocacy Program – 3080 Lower Elwha Rd., Port Angeles, WA  98363

Lower Elwha Family Advocacy Program operates in different grants to deliver and refer services to American Indians, Alaskan Native and/or Lower Elwha Tribal community members who are victims of domestic violence, sexual assault, dating violence, stalking, and elder abuse that resides within the geographic services area of the Lower Elwha Klallam Tribe. Services are free, confidential, and unlimited except for financial assistance.

(360)-460-1745 or (360)-775-9346

Mariposa House – 81 S 2nd Ave, Forks, WA 98331

Offers resources for victims of Domestic Abuse and Sexual Assault, including an Emergency Shelter, Advocacy, and Support Groups.

Open Monday-Friday 9:00am-3:00pm

24-Hour Crisis Line: 360-374-2273

Employment Services

Morningside – 113 S Valley St, Port Angeles, WA 98362

Employment services, training and placing Port Angeles and Sequim residents in retail, office, and transportation positions.

360-452-7919

Pierce, Jones, and Associates LLC– 210 Center Park Way, Sequim, WA 98382

Offers a variety of employment and financial security based services, including: assessments, job development and placement, life skill training, and education about Social Security.

360-582-9965

Also see Concerned Citizens (Child Care) and OlyCAP (Heating and Utility Assistance)

Food

Lutheran Community Services Northwest – 2610 S Francis St, Port Angeles, WA 98362

Services include: Basic needs and crisis assistance, Resource information and community referrals, Assistance signing up for food stamps, Washington Basic Health and other government programs, Computer access for job search, Child Check preschool screenings, Parent coaching, and Classes on budget management, health and nutrition. 

Port Angeles Food Pantry open Monday-Friday 9:00am-3:00pm

360-452-5437

Port Angeles Food Bank – 632 N. Oakridge Dr., Port Angeles, WA 98362

The Port Angeles Food Bank is a no-barrier food bank nourishing anyone in need in Clallam County.

Wednesday and Friday 11:00am-2:30pm, Saturday 10:00am-1:00pm

360-452-8568

Salvation Army – 206 S. Peabody Street, Port Angeles, WA

Services Offered: Disaster Services, Emergency Financial Assistance, Substance Use Disorder Services, Emergency Shelter, Food & Nutrition Programs, and Music & Arts Programs

360-452-7679

Sequim Food Bank – 144 W Alder St, Sequim, WA

Food available to residents within the Sequim School District twice per month.

Monday 1:00pm-4:00pm, Friday and Saturday 9:00am-12:00pm

360-683-1205

Also see Forks WIC, Port Angeles WIC, and Sequim WIC (Women’s Healthcare),

Healthcare

Lower Elwha Health Clinic – 243511 Hwy 101 West, Port Angeles, WA  98363

​The Lower Elwha Health Department provides Medical Primary Care, Dental, Mental Health and Substance Abuse Services to the community. Each department provides quality healthcare to members of the Lower Elwha Klallam Tribe, enrolled members of other federally recognized tribes, and most services to non-native members of the community.  No Walk Ins.

Monday-Friday 8:00am-6:00pm

360-452-8471

Quileute Health Clinic – 560 Quileute Heights Loop, La Push, WA 98350

Provides health care, including dental care and behavioral health care, to the Quileute nation.

(360) 374-9035

Sea Mar Port Angeles Dental Clinic – 228 W 1st St., Port Angeles, WA

Sea Mar provides sliding fee scale discounts for eligible patients, dependent on household size and annual income.

Monday-Saturday 8:00am-5:00pm

360-406-5260

The Sequim Free Clinic – 777 North Fifth Avenue, Suite 109, Sequim, WA 98382

Chronic Healthcare Clinic visits are by appointment on Tuesdays from 12 noon to 4:30 pm

Basic Urgent Care Clinic Hours Monday and Thursday: beginning at 4:45pm

360-582-0218

Volunteers in Medicine of the Olympics – 819 E. Georgiana St., Port Angeles, WA 98362

Volunteers in Medicine of the Olympics, or VIMO for short, is a volunteer medical, behavioral health and dental clinic in Port Angeles, WA. VIMO is a free clinic, primarily serving low-income and homeless patients living in Clallam and Jefferson counties.

Monday-Friday: 9:00am-5:00pm

Medical Clinic: 360-457-4431; Dental Clinic: 360-477-4120

Heating and Utility Assistance

OlyCAP – 228 W 1st Street, Suite J, Port Angeles, WA 98362 and 421 5th Ave, Forks, WA 98331

Provides housing and heating help, employment assistance, and early childhood services

Port Angeles: 360-452-4726; Forks: 360-374-6193

Also see Salvation Army (Food)

Housing

Peninsula Housing Authority – 2603 S. Francis Street, Port Angeles WA 98362

Peninsula Housing Authority is a special purpose government agency providing long term rental housing, tenant based rental subsidies and a homeownership housing program in Clallam and Jefferson Counties. They provide affordable housing opportunities for the following types of households; low-income disabled, low-income elderly and general low-income.

Monday-Thursday: 9:00am-4:00pm & Friday: 9:00am-12:00pm

Port Angeles Office: 360-452-7631; Forks Office: 360-374-5604

Serenity House Housing Resource Center – 2203 West 18th, Port Angeles, WA; 583 W. Washington Street, Sequim; and 287 Founders Way, Forks, WA

Has housing specialists who can help with Coordinated Entry, Emergency Housing, Transitional Housing, and referrals for other critical services.

Monday-Friday: 9:00am-12:00pm and 1:00pm-5:00pm

Port Angeles:360-452-7224 ex. 1; Sequim: 360-682-9442; Forks: 360-670-4934; Shelter Services: 360-452-7221

Also see OlyCAP (Heating and Utility Assistance) and Salvation Army (Food)

IDD Support

Clallam Mosaic – 205 Black Diamond Road, Port Angeles, WA  98362

Offers an array of services for those with developmental disabilities and their caregivers, including art classes, general skill classes, social events, and Parent 2 Parent resources.

Monday-Friday: 9:00am-3:00pm

360-797-3602

Developmental Disabilities Field Office – 201 W 1st St Suite 2, Port Angeles, WA 98362

Monday-Friday 8:00am-5:00pm

360-912-8310

Also see Concerned Citizens (Child Care)

Legal Support

Jefferson-Clallam County Pro Bono Lawyers – 528 W. 8th Street, Port Angeles, WA 98362

Clallam-Jefferson County Pro Bono Lawyers provides legal assistance to low income residents of Clallam and Jefferson County. To request Pro Bono services, you must first call the Clear Line at 1-888-201-1014.  CLEAR will determine if you are eligible for services.

The Clallam County Courthouse Facilitator also provides help with family law court forms and court procedures. The Court Facilitator may be reached at 360-417-2588.

360-504-2422

Transportation

Clallam Paratransit – 830 W Lauridsen Blvd, Port Angeles WA 98362

Clallam Transit System provides curb-to-curb service with assistance for elderly and disabled persons in Clallam County. CTS paratransit service locations and times are comparable to CTS fixed route service. This is a shared origin-to-destination service with your fellow passengers.

For Reservations: Monday-Saturday:  8:00am-4:00am

360-452-4511 ex. 1 or 1-800-858-3747 ex. 1

Clallam Transit – 830 W Lauridsen Blvd, Port Angeles WA 98362

Offers regular service around Clallam County and beyond.  Fares cost $1.00-1.50 per person, with discounts available with the Regional Reduced Fare Permit (RRFP) for seniors and individuals with disabilities.  RRFP must be applied for in person.

Offices open Monday-Friday:  9:00am-4:00am

1-800-858-3747

Women’s Healthcare

Forks WIC – 140 C Street, Forks, WA 98331

Women, Infants and Children (WIC) Program is a nutrition education, health promotion, and supplemental food program to assist eligible women, infants, and children who have nutritional needs.

Tuesday, Thursday, Friday: 8:30am-12:00pm, 1:00pm-4:30pm

360-374-3121

Planned Parenthood Health Center – 426 East 8th Street, Port Angeles, WA 98362

Services include women’s health care, birth control, STD testing and treatment, and men’s health care.

Open Monday and Wednesday, 10:00am–6:00pm

1-800-769-0045

Port Angeles WIC Clinic – 111 East 3rd Street, Port Angeles, WA 98362

Women, Infants and Children (WIC) Program is a nutrition education, health promotion, and supplemental food program to assist eligible women, infants, and children who have nutritional needs.

Monday, Thursday, Friday: 9:00am-12:00pm, 1:00pm-4:00pm

360-417-2275

Sequim WIC – 583 W. Washington St. Sequim, WA 98382

Women, Infants and Children (WIC) Program is a nutrition education, health promotion, and supplemental food program to assist eligible women, infants, and children who have nutritional needs.

Tuesday: 8:30am-12:00pm, 1:00pm-3:30pm

360-417-2275

Youth Services

Olympic Peninsula YMCA – 675 North 5th Ave., Suite 3A, Sequim, WA 98382

Facilities include a pool, wellness center, gymnasium, youth sports, summer day camp, and CPR Certification

Monday-Friday 5:00am-8:00pm and Saturday 8:00am-5:00pm

360-477-4381

The Answers for Youth (TAFY) – 826 East First Street, Port Angeles

Provides food, showers, laundry facilities, clothing, shoes, tents, sleeping bags, transportation, first aid, healthcare, GED resources, recovery programs, and legal document help for area homeless.

Monday, Wednesday, Friday: 3:00pm-7:00pm & Saturday: 4:00pm-7:00pm

360-670-4363

The Drop – 110 E 7th Street, Port Angeles, WA 98362

A youth and young adult (12-24) drop-in center that is LGBTQ+ friendly. The services include: providing a safe, warm, welcoming and judgment free space for youth to receive services, housing assistance, employment and education referrals, mental health and counseling referrals, schooling and program availabilities, communication tools and much more.

Monday-Friday 9:00am-5:00pm

360-504-3387

YMCA of Port Angeles – 302 S. Francis Street, Port Angeles, WA 98362

Facilities include a Wellness Center, Summer Day Camp, Ball Courts, and Locker Room

Monday – Friday: 5:00am-8:00pm & Saturday 8:00am-5:00pm

360-452-9244

Also see Boys & Girls Club (Child Care)

The No Surprises Act Begins January 2022: This is What You Can Expect

The “No Surprises Act,” which establishes new federal protections against most surprise out-of-network medical bills when a patient receives out-of-network services during an emergency visit or from a provider at an in-network hospital without advance notice, will take effect next month. A new KFF brief outlines what to expect in 2022, summarizing key provisions that will be implemented.

Most adults (2 in 3) say they worry about unexpected medical bills and among privately insured patients, about 1 in 5 emergency claims and 1 in 6 in-network hospitalizations include at least one out-of-network bill. The new federal protections will apply to most surprise bills for emergency care, as well as for non-emergency services provided at in-network facilities, potentially helping alleviate this worry.

The No Surprises Act prohibits providers from billing patients more than the applicable in-network cost sharing amount in these situations. Starting in 2022, providers will need to find out patient’s insurance status before submitting the surprise out-of-network bill directly to the health plan. However, patients can give written consent to waive their rights under the No Surprise Act and be billed more by out-of-network providers. It is expected this should only happen in limited circumstances.

The brief also describes procedures to arrive at payment amounts for surprise bills, including use of an independent dispute resolution (IDR) system. Under this system, it is likely that out-of-network payments will be close to the median rate that health plans pay for in-network services, and this would moderate health plan premiums overall. However, suits filed by provider organizations are pending and could result in further regulatory changes or delay implementation of the law.

If a patient receives what they believe is a surprise bill, the new brief highlights protections, and ways to seek help. This is a complex law, with enforcement being conducted in a variety of ways, both by federal and state agencies.

The No Surprises Act allows consumers to appeal disputes over coverage of surprise medical bills to an external reviewer. Another new KFF brief looks at the process for consumer appeal rights under the Affordable Care Act (ACA), which would also be used for surprise bills. Federal law gives consumers the right to appeal health plan claims denials and other adverse decisions, including the incorrect application of cost sharing, although limits apply. This brief describes consumer access to appeals and limits on appeal rights that have been adopted through federal regulations.

Washington Healthplanfinder Announces Statewide Adventure Tour

Visit one of the base camps at the cities below and speak to someone who can guide you through the sign-up process.

Keep an eye out for the Washington Healthplanfinder adventure van at these times and places:

Nov. 27 | Bellingham, WA
First Friday Shop Local | 4 pm – 9 pm | 1336 Cornwall Ave.

Dec. 3 | Moses Lake, WA
Moses Lake Street Party | 5 pm – 8 pm | Sinkiuse Square on Third Avenue

Dec. 4 | Walla Walla, WA
Farmer’s Market and Holiday Parade | 9 am – 7 pm | 106 W Main St.

Dec. 9 | Tri-Cities, WA
After School Pop-Up with Tri-City Health | Time to be determined

Dec. 10 | Vancouver, WA
Vancouver Mall (outdoor courtyard) | 11 am – 5 pm | 8700 NE Vancouver Mall Dr.

Dec. 11 | Wenatchee, WA
Pybus Public Market | 10 am – 6 pm | 7 N Worthen St.

Dec. 17 | Olympia, WA
Oly on Ice | 3:30 pm – 9 pm | 529 4th Ave. W

Dec. 18 | Seattle, WA
Children’s Home Society in Kent (King County Public Health) | 10 am – 4 pm | 215 5th Ave. S, Kent, WA

Dec. 19 | Yakima, WA
Los Hernandez Tamales | 2 pm – 6 pm | 3706 Main St., Union Gap, WA

Jan. 7 | Spokane, WA
Spokane First Friday | 1 pm – 8 pm | 1318 W 1st Ave.

Dying Patients With Rare Diseases Struggle to Get Experimental Therapies

At 15, Autumn Fuernisen is dying. She was diagnosed at age 11 with a rare degenerative brain disorder that has no known cure or way to slow it down: juvenile-onset Huntington’s disease.

“There’s lots of things that she used to be able to do just fine,” said her mom, Londen Tabor, who lives with her daughter in Gillette, Wyoming. Autumn’s speech has become slurred and her cognitive skills slower. She needs help with many tasks, such as writing, showering and dressing, and while she can walk, her balance is off.

Autumn has been turned down for clinical trials because she is too young.

“It is so frustrating to me,” Tabor said. “I would sell my soul to try to get any type [of treatment] to help my daughter.”

For patients like Autumn with serious or immediately life-threatening conditions who do not qualify for clinical trials and have exhausted all treatment options, there may be another option: seeking approval from the Food and Drug Administration for expanded access, or compassionate use, of experimental therapies.

Read the full article from KHN.

A Hospital Charged $722.50 to Push Medicine Through an IV. Twice.

Claire Lang-Ree was in a lab coat taking a college chemistry class remotely in the kitchen of her Colorado Springs, Colorado, home when a profound pain twisted into her lower abdomen. She called her mom, Jen Lang-Ree, a nurse practitioner who worried it was appendicitis and found a nearby hospital in the family’s health insurance network.

After a long wait in the emergency room of Penrose Hospital, Claire received morphine and an anti-nausea medication delivered through an IV. She also underwent a CT scan of the abdomen and a series of tests.

Hospital staffers ruled out appendicitis and surmised Claire was suffering from a ruptured ovarian cyst, which can be a harmless part of the menstrual cycle but can also be problematic and painful. After a few days — and a chemistry exam taken through gritted teeth — the pain went away.

Then the bill came.

Patient: Claire Lang-Ree, a 21-year-old Stanford University student who was living in Colorado for a few months while taking classes remotely. She’s insured by Anthem Blue Cross through her mom’s work as a pediatric nurse practitioner in Northern California.

Total Bill: $18,735.93, including two $722.50 fees for a nurse to “push” drugs into her IV, a process that takes seconds. Anthem’s negotiated charges were $6,999 for the total treatment. Anthem paid $5,578.30, and the Lang-Rees owed $1,270 to the hospital, plus additional bills for radiologists and other care. (Claire also anted up a $150 copay at the ER.)

Read the full article from Kaiser Health News.

Supreme Court Declines to Overturn ACA — Again

The Supreme Court on Thursday turned back its third chance to upend the Affordable Care Act, rejecting a lawsuit filed by a group of Republican state attorneys general claiming that a change made by Congress in 2017 had rendered the entire law unconstitutional.

By a vote of 7-2, however, the justices did not even reach the merits of the case, ruling instead that the suing states and the individual plaintiffs, two self-employed Texans, lacked “standing” to bring the case to court.

“We proceed no further than standing,” wrote Justice Stephen Breyer for the majority. “Neither the individual nor the state plaintiffs have shown that the injury they will suffer or have suffered is ‘fairly traceable’ to the ‘allegedly unlawful conduct’ of which they complain.”

The two dissenters in the case, Justices Samuel Alito and Neil Gorsuch, disagreed. “The States have clearly shown that they suffer concrete and particularized financial injuries that are traceable to conduct of the Federal Government,” Alito wrote. “The ACA saddles them with expensive and burdensome obligations, and those obligations are enforced by the Federal Government. That is sufficient to establish standing.”

The ruling represented a win not only for backers of the health law in general, but also for Health and Human Services Secretary Xavier Becerra. As California attorney general, Becerra led the Democratic states defending the ACA after the Trump administration sided with the Republican states’ suit.

Read the full article from KHN.

Insurance Transition

If you are still on your parent’s health insurance at age twenty-six, you will be required to perform a transition process as, after age twenty-six, you are no longer automatically covered. It is important to understand your insurance options so that you can pick the coverage that works best for you. 

Options may include solely being covered under Medicaid at no cost to you, paying for your own health insurance (private or state), or fulfilling the process that must occur to continue being covered under your parent’s insurance if that insurance company and your parents allow you to do so.

Learning Objectives:

  • Know that at age 26, dependents are no longer automatically covered by their parent’s insurance
  • Understand the choices that you have when you are going to turn 26
  • Understand the process that must occur when you are going to turn 26 in order to continue having health insurance
  • Understand the choices that you have when you are already 26
  • Understand the choices that you have when you are married
  • Know what questions to ask your current insurance company 
  • Know what questions to ask potential insurance companies when searching for a new coverage plan

Insurance Choices
The Process
Questions to Ask Your Current Insurance Company
Questions to Ask Potential Insurance Companies
Glossary

Medical Self-Advocacy

Self-Advocacy and leadership are important skills for every aspect of life. However, this is even more so when it comes to taking charge of your own healthcare and other medical needs. 

As you may already know, many youth and young adults with disabilities and/or complex medical needs often have advocates while growing up. You, yourself, may have had an advocate, but it is very possible that you have decided that it is time to begin developing the skill of self-advocacy in order to take leadership in your own healthcare as it is an important skill in the development of becoming your own self-advocate. 

Self-advocacy and taking leadership in your own healthcare does not happen overnight. These skills are a process and you can continue to learn and grow in these areas throughout your entire life. However, beginning as a youth or young adult will allow you to build a firm foundation before venturing out on your own.

Learning Objectives:

  • Be prepared for transitioning from having an advocate to taking leadership in your own healthcare 
  • Understand what it means to be a self-advocate
  • Understand how to become a self-advocate
  • Understand what it means to take leadership in your own healthcare 
  • Learn the resources available to you while becoming a self-advocate and leader in your own healthcare

All about Self-advocacy

Know Your Rights and Responsibilities 

Taking Leadership in Your Healthcare