NOHLA UPDATE HEALTH ACCESS ISSUES WCOMO PUGET SOUND MEETING

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1 NOHLA UPDATE HEALTH ACCESS ISSUES WCOMO PUGET SOUND MEETING Ann Vining, Staff Attorney Northwest Health Law Advocates December 16, 2016

2 Federal Law Potential Issues 2 For Health Care programs we have More Questions than Answers Now See letter from Washington s Governor and Insurance Commissioner Long list of things that could be affected

3 Federal Law Potential Issues 3 Medicaid expansion Cost sharing/premium subsidies for QHPs Insurance exchange Contraceptive coverage without cost Gender blind premiums

4 Federal Law - Potential Issues 4 Youths on parent plans to age 26 No coverage cost cap Preexisting condition coverage Essential benefits requirements Reauthorization of CHIP

5 Federal Law Potential Issues 5 Yes, power is there to disrupt what we have Budget Reconciliation takes 51 Senate votes, not 60 House v. Burwell litigation Likely attempt to pass repeal legislation with a delay of 1 to 3 years to pass a replacement Efforts happening to get some Republican Senators to vote against it If it happens, not likely to affect coverage in the short term unless insurance industry is affected

6 Federal Law Potential Issues 6 MESSAGE for navigators and clients: It hasn t changed yet. Sign up for the coverage you need now. Get the services you need now. Take care of business!

7 Federal Law Potential Issues 7 MESSAGE for navigators and clients who are worried/concerned about changes: Contact your elected officials (state legislators, Congressional reps, Senators) about your concerns Share or be prepared to share coverage stories and concerns for the future

8 Federal Law Potential Issues 8 Stories - Everyone wants them (Legislators, advocates, media) How the benefits I m getting are vital for me, difference they made and impact if I lose them Need specific issues, at specific times

9 Federal Law Potential Issues 9 But -- will changes happen? There is no crystal ball! Now that changes won t be vetoed major players are weighing in (example: Insurance industry actuaries letter) Advocacy groups are coordinating NoHLA involved

10 Federal Law Potential Issues 10 Stay tuned! Watch for news of outcomes Watch for alerts about opportunities, things you can do Suggested Sources WCOMO newsletters, NoHLA updates

11 State Legislative Issues 11 Healthy Washington Coalition Ensuring Washington State has quality, affordable health care coverage for all of its residents Includes community organizations, labor unions, health plans, faith-based groups, patient groups, provider associations NoHLA and CHNWA are members

12 State Legislative issues 12 Healthy Washington Coalition Legislative priorities (just adopted): Protect and Preserve our State s Health Care Coverage Maintain and Expand Coverage though WSHIP (Wa State High-risk Insurance Pool) Prescription Drug Cost Transparency

13 State Legislative Issues 13 Healthy Washington Coalition Legislative priorities (cont.): Expand Coverage to Young Adults Left Out Women s Contraceptive Health Care Website for more info about Healthy Washington Coalition:

14 State Legislative Issues 14 Surprise Billing Bills consumers don t expect from out-ofnetwork providers Legislation to prohibit surprise billing is being requested by Insurance Commissioner

15 State Legislative Issues 15 NoHLA will do updates of state legislative issues as well as federal law updates. Watch WCOMO newsletters for info about NoHLA updates

16 Administrative Issues 16 Pregnancy Churn Watch for materials coming out soon Women who are on QHPs, report pregnancy on healthplanfinder, are eligible for Medicaid, are automatically enrolled in Medicaid and lose QHP

17 Administrative Issues 17 Pregnancy churn (cont.) Some women want to stay on QHP instead (examples: to keep provider not available in Medicaid, or keep alternative care services not provided by Medicaid) Can avoid reporting, or use a work around to be described in materials coming out soon

18 Administrative Issues 18 AREP not needed to do follow-up for clients with a Request for Retroactive Coverage (Form ) Use authorization to release form, HCA form , signed by client enter in search box: , or release

19 Administrative Issues 19 Eligibility and Service Access Client option to file grievance or appeal Legal help through CLEAR ( outside King County; or in King County) Repeated, systems problems NoHLA wants to hear about these

20 Last But Not Least. 20 Watch for NoHLA s Navigator Survey, coming out soon This is different from the HBE survey you did last month We appreciate your feedback and info on our survey it helps us do our work better

21 21 Thank You! Ann Vining Staff Attorney Northwest Health Law Advocates