June 28, 2013

June 28 Washington Update

Greetings from Washington, DC!  The big news last week is the administration's push to get the word out about how to enroll in a health plan through a Health Insurance Marketplace (Exchange).  Also in the news - immigration reform and an updated tool to help consumers compare physicians.


On Wednesday, July 10 at 2:00 (to 3:30) pm Eastern (11 am Pacific) the Center on Budget and Policy Priorities (CBPP) will present the next webinar in its ACA ‘Beyond the Basics' series, which will focus on employer responsibility and coordination with the exchange.  See below for archives of the previous webinars in this series, on premium assistance and cost-sharing subsidies. 

Health Insurance Marketplaces (Exchanges).  CMS has announced series of training webinars about Exchanges. There will be two levels, basic and advanced.  Space is limited, but the webinars are offered on multiple dates.  See the end of this update to register.

New HRSA Video Series on Grant Applications [always available].  A HRSA video series is intended to debunk the myths surrounding the grant application process and provide tips for how to submit a successful application.  In short animated segments, the series explains grant eligibility, planning for and preparing your submission and the approval process.  See:  Video Series; How to Apply for a Grant.


Revised ACA website and toll-free number now operational!  Last Friday night HHS quietly relaunched its www.healthcare.gov website and a 24/7 hotline to help people enroll in health care plans as of October 1.  This week, though, the administration blasted the news through cyberspace and announced several other sources of information about implementation of the Affordable Care Act (ACA).  They have asked organizations like ours to spread the word so that the public is ready to (en)roll come October 1.  Here are links to resources:

http://www.hhs.gov/healthcare/rights/index.html - summary of ACA

www.healthcare.gov - information for consumers about how to select and enroll in an insurance plan through the applicable Marketplace/Exchange, and additional information .  Over the summer, the site will continue to add new functions to help consumers to shop for affordable qualified health plans.  The website is built with a responsive design so that consumers may access it from their desktops, smart-phones, and other mobile devices. In addition, the website is available via an application interface at www.healthcare.gov/developers (whatever that means).

CuidadoDeSalud.gov - Spanish version of healthcare.gov.

Toll-free number (1-800-318-2596) - consumer call center that will be open 24 hours a day, seven days a week to answer questions and, starting in October, to provide personalized assistance for callers filling out their application or selecting a plan.  The hotline will provide services in 150 languages. 

FAQs about the ACA -- https://questions.cms.gov/faq.php?id=5005&rtopic=1993

Social Media sites -- Facebook.com/HealthCare.gov or Facebook.com/CuidadoDeSalud.gov and

Twitter @HealthCareGov or @CuidadoDeSalud.

Infographics - posters about preventive health care and the ACA.

PSA videos that can be run on short-circuit TV networks in waiting rooms and on agency YouTube channels. 

NEW Marketplace widget and badges in English and Spanish that can be put on websites and sent out through social media. 

 http://marketplace.cms.gov/ -- Source for the latest resources for consumers and those assisting them, including brochures, fact sheets, posters, postcards, and checklists.

Other promotion of the ACA.  Last week, the organization Enroll America launched the"Get Covered America!" campaign, which will reach out to the uninsured in multiple ways: knocking on doors, handing out brochures in public places, advertising on television and radio, and partnering with churches, civic groups, hospitals and, possibly sports leagues and celebrities.  

Also last week, Organizing for America, a political advocacy group created from the Obama reelection campaign, aired its first pro-ACA television ad.  

CMS has also reformatted its display of ACA-related FAQs in the State Resource Center on Medicaid.gov. They are now sortable and searchable, rather than being stored in .pdf documents.  See


Interesting articles on ACA implementation. In this article, our own Rylin Rodgers of Indiana Family Voices discusses how important the ACA has been to her family.  "How Much Will Obamacare Cost?" and "Big Changes Ahead For Those Who Buy Their Own Insurance" discuss how much insurance might cost after health reform is implemented.  "California's Health Insurance Exchange at Forefront" discusses the importance of California in successful ACA implementation, since it is home to many of the young, healthy uninsured that must enroll in order to ensure that premiums remain reasonable. 


This week, Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner announced the redesign of Physician Compare, a website that allows consumers to search and compare information about hundreds of thousands of physicians and other health care professionals.  The site has been redesigned to make it easier to use.  It includes an improved search function and will provide more frequently updated information.  In 2014 quality data will be added so that users can select a medical professional based on performance ratings.

Physician Compare was improved based on user and partner feedback, as part of improvements in the Affordable Care Act. The redesign includes new information on physicians, such as:

  • Information about specialties offered by doctors and group practices;
  • Whether a physician is using electronic health records;
  • Board certification; and
  • Affiliation with hospitals and other health care professionals.

The Physician Compare website is at http://www.medicare.gov/physiciancompare.  A video highlighting the main features of the redesign is available at http://www.youtube.com/user/CMSHHSgov.  For questions or concerns, contact HHSIEA@hhs.gov.

F2F FUNDING.  Current cosponsors of the Senate bill (S. 423 [corrected number]), sponsored by Senator Robert Menendez (D-NJ), are Senators Sheldon Whitehouse (D-RI), Al Franken (D-MN), Amy Klobuchar (D-MN), and Elizabeth Warren (D-MA).  The House bill (H.R. 564), sponsored by Congressman Frank Pallone (D-NJ), is cosponsored by Representative David Cicilline (D-RI).  If you would like to contact your Representative and/or Senators to urge them to cosponsor one of these bills, you can find their contact information at http://www.congressmerge.com/onlinedb/index.htm

      {Remember:  no federal resources can be used to contact your elected officials about cosponsoring the legislation.}

IMMIGRATION REFORM.   The immigration reform bill passed by the Senate this week includes some provisions helpful to children, but not in the area of health care.  See this five-page summary and analysis of the bill from First Focus, and this summary table from the National Immigration Law Center (NILC).  (Beware that, on another page of the NILC website, the FAQs about health care provisions are now outdated.)


Health Insurance 101.  Community Catalyst and Georgetown University's Health Policy Institute created a Health Insurance 101 online guide on private health insurance.  The guide is intended to help consumer advocates answer critical questions about private insurance:  What is health insurance and how does it work?  How do people get health insurance today?  How will health insurance change under health care reform?  Answers to questions about fully insured employer health plans, self-insured employer health plans, medical underwriting, and more are provided.

Premium Tax Credits.  The Center on Budget and Policy Priorities (CBPP) held a webinar on June 5 about premium tax credits under the ACA.  A recording of the session (with synched slides) is available on YouTube, and the slides alone can be found here.  The Center has also prepared a fact sheet on Frequently Asked Questions about premium tax credits.    

Cost-sharing reductions.  Slides from this CBPP webinar can be found here.  [Note: There was an error on the original slides (slide 7) regarding the federal requirement for the maximum out-of-pocket limit for marketplace plans in 2014.  The correct amount - reflected in the slide deck posted- is $6,350 for a plan that covers an individual and $12,700 for a plan that covers a family. These amounts, which cap what people must pay in cost-sharing charges in their health plan each year, will be reduced for individuals and families receiving cost-sharing reductions.]  More resources on this topic will be posted later. 

Navigators and In-Person Assisters: 

Families USA Navigator and In-Person Assister Resource CenterSign up to receive updates.

Georgetown Center on Children and Families blog post, about training and other elements needed for an effective consumer assistance system.  This outline could be helpful to advocates attempting to shape a state's policy with respect to consumer assistance training and support.

From CMS: Helping Consumers Apply and Enroll Through the Marketplace (explains the different types of "navigators," "assisters" and "application counselors")

StateRefor(u)m, a project of the National Academy for State Health Policy (NASHP) and the Robert Wood Johnson Foundation, has a wealth of information on state ACA implementation, including draft/final regulations on consumer assistance plans in California and Minnesota.

Eligibility and Enrollment:

Issue brief from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured identifies five key lessons based on a review of existing research on previous outreach and enrollment experience in Medicaid and the Children's Health Insurance Program. 

Available here is a webcast of a session held by Families USA and Enroll America that discusses: (1) tactics for successfully engaging uninsured people, particularly communities of color, to get them enrolled in health insurance, and (2) best practices for raising public awareness about the health insurance options available under the ACA. 

Information on "Churning": The Continuity of Medicaid Coverage is a report from George Washington University explaining the benefits of minimizing disruptions for Medicaid enrollees.  It includes an updated analysis of rates of continuity of coverage in each state and recommendations for states to address churn by such methods as easing the yearly renewal process and using electronic income verification.  Eligibility, Enrollment and Churn Recommendations, are recommendations adopted by the District of Columbia exchange board for easing eligibility processes and reducing churn through such tactics as not requiring reporting of income changes of less than $150 per month; requiring QHPs to have transition plans for enrollees moving on or off the plans; and granting "good faith" extensions of deadlines to resolve inconsistencies in an application.

MAGI rules for Medicaid Eligibility, provides three versions of a flow chart designed to map the steps for determining a person's eligibility for Medicaid under the new MAGI rules. Find the charts and post your comments here.

State-Specific Information (from StateRefor(u)m, which also has other resources):

State Approaches to Qualified Health Plan Certification Chart, which shows how much authority each exchange or partnership state has in the various domains related to certifying health plans to be sold in an exchange. Includes links to source documents.  The recording and slides from a webinar on three states' certification methods, including Q & A, are also available.

State and Partnership Exchange Policy Decisions Chart, which identifies various decisions states must make with respect to Exchange implementation, such as with the eligibility system will include Medicaid, how to approach consumer assistance; how to finance the exchange; and how much authority over insurance plans they will have.  Includes links to source documents.

Medicaid Expansion Update and Resources:

50-State Look at the Medicaid Expansion explains the basic facts about the status of Medicaid expansion.

CBPP's (Center on Budget and Policy Priorities) Medicaid Expansion Toolkit

NHeLP Medicaid Expansion Toolbox, to be updated continually.

ACA information and subscriptions to updates can also be found at:

1.     HealthCare.gov: This site is geared towards consumers and provides general information about the Marketplace and health insurance. Consumers can sign up for email and/or text message updates.

2.     Marketplace.cms.gov: This is the main avenue that CMS will use to communicate with interested stakeholders on Marketplace updates. It provides a wide variety of tools and resources to help people prepare to apply, enroll and get coverage in 2014. You can also sign up for updates by clicking on "Get updates." After entering your email address, check the box that says "Health Insurance Marketplace (Exchange)" under the "Outreach and Education" section near the middle of the page.  To submit comments or make inquiries, contact partnership@cms.hhs.gov.


As always, please feel free to contact us with any questions. 

Best, Janis & Brooke

Janis Guerney, Esq.

Brooke Lehmann, MSW, Esq.



[NOTE:  There are two lists of webinars below, from different sources within HHS.  The second provides additional dates/times for the "Level 1" webinars.]

  • Level 1: Health Insurance Marketplace 101 (basic) - A one-hour high-level webinar overview of the accomplishments of the Affordable Care Act and a basic introduction to the Marketplace (Exchanges) highlighting who is eligible and how the Marketplace will work.
  • Level 2: Understanding the Health Insurance Marketplace (advanced) - A two-hour detailed review of the Marketplace (Exchanges), including eligibility, enrollment, plan structure, Medicaid expansion, and the streamlined application.

Select the webinar that best suits your needs and then select the Registration Link that corresponds with the date to register for the webinar.  Please note that there is a limit of 200 people for each of the webinars and will be filled on a first come first serve basis.

NOTE:  In the fields asking for agency and division/group, enter ‘NA'.  Although I understand that some people are able to register without a problem, I had technical difficulty registering last week.  Today I was successful, so if you've had problems, you might want to try again also.

Level 1: Health Insurance Marketplace 101



1:00 - 2:00 pm ET




1:00 - 2:00 pm ET




1:00 - 2:00 pm ET




1:00 - 2:00 pm ET




1:00 - 2:00 pm ET




1:00 - 2:00 pm ET



Level 2: Understanding the Health Insurance Marketplace



1:00 - 3:00 pm ET




1:00 - 3:00 pm ET




For more information on these and other events hosted by the Centers for Medicare & Medicaid Services, email the CMS National Training Program at training@cms.hhs.gov.  Marketplace information and training materials for partners is available at Marketplace.cms.gov.


 The Health Care Law - Health Insurance Marketplace 101 July 11 at 2:00 pm ET

The Health Care Law - Health Insurance Marketplace 101 August 7 at 3:00 pm ET

A presentation on the main provisions in the health care law (the Affordable Care Act) and how to access care in your community. Topics include the Health Insurance Marketplace, how to enroll in health insurance, and how to receive updates on implementation of the law. A brief question and answer session will provide answers to commonly asked questions.