Federal Policy
The Community Health Network of Washington (CHNW) promotes public policies to increase access to health insurance and health care and reduce the number of uninsured people in our state.
On March 23, 2013, we celebrate the third anniversary of the Affordable Care Act (ACA)! Since 2010, millions of Americans have benefited from the important changes brought by health care reform and we look forward to even more improvements coming in January 2014.
In the last three years, the ACA has demonstrated its commitment to vulnerable populations by increasing funding to Community Health Centers and primary care physicians. Health Center grantees in Washington have received over $79 million to support ongoing health center operations and to establish new health center sites, expand services, and/or support major capital improvement projects.
We have seen the number of National Health Service Corps (NHSC) clinicians grow due to expanding investments in the last three years. The NHSC repays educational loans and provides scholarships to primary care physicians, dentists, nurse practitioners, physician assistants, behavioral health providers, and other primary care providers who practice in areas of the country that have too few health care professionals to serve the people who live there. As of September 30, 2012, there were 366 Corps clinicians providing primary care services in Washington compared to 78 in 2008.
Also in the last three years, Washingtonians have enjoyed increased benefits to both their health and pocketbooks in the following ways:
Increased coverage for young people
Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family coverage, and, thanks to this provision, as of December 2011, 62,000 young adults in Washington gained insurance coverage as a result of the health care law.
Making prescription drugs affordable for seniors
The Affordable Care Act makes prescription drug coverage (Part D) for people with Medicare more affordable. It does this by gradually closing the gap in drug coverage known as the "donut hole." Since the enactment of the law, people with Medicare in Washington saved over $95 million on prescription drugs. In 2012 alone, 57,000 individuals in Washington saved over $41 million, or an average of $719 per beneficiary.
Covering preventive services with no deductible or co-pay
The health care law requires many insurance plans to provide coverage without cost sharing to enrollees for a variety of preventive health services and in 2011 and 2012, over 1.6 million Washingtonians benefited from this change. For policies renewing on or after August 1, 2012, women can now get coverage without cost-sharing of even more preventive services they need, which means approximately 1 million women in Washington will now have guaranteed access to additional preventive services.
This provision of the Affordable Care Act also removes barriers for people with Medicare. In 2012, half a million seniors and people with disabilities in Washington used one or more free preventive service to stay healthy by detecting and treating health problems early.
CHNW is looking forward to the coverage expansions of 2014 and is working to influence the development and implementation of the Health Benefit Exchange and Medicaid expansion.
The Affordable Care Act will expand health insurance coverage by establishing a Health Insurance Marketplace in every state and increasing access to the Medicaid program. Over 800,000 of Washington’s non-elderly residents are uninsured, of whom approximately 758,000 (91%) may qualify for either tax credits to purchase coverage in the Marketplace or for Medicaid coverage.
Supporting Washington’s work on Affordable Insurance Exchanges
Washington has received nearly $152 million in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges. The Washington Healthplanfinder will go live on October 1, 2013 for consumers to apply for Medicaid, individual and small group health insurance coverage.
Increasing Access to Medicaid
The Affordable Care Act also fills in gaps in coverage for the poorest Americans by giving states the option to expand Medicaid to individuals under 65 years of age with income below 133 percent of the federal poverty level (FPL) (approximately $14,000 for an individual and $29,000 for a family of four) beginning in January 2014. States will receive 100% federal funding for the first three years to support this expanded coverage, phasing to 90% federal funding in subsequent years. In addition, Medicaid and Children's Health Insurance Program (CHIP) eligibility and enrollment will be much simpler and will be coordinated with the Marketplace.
CHNW’s top priority is to work with the State Legislature to approve and implement the full Medicaid expansion. We know this is the clear choice for Washington, bringing $225 million in savings in this biennium and increasing health insurance coverage to over 261,000 more of our friends and neighbors.
Our current federal advocacy efforts include:
- Protecting public programs and the Community Health Centers across the state from harmful budget cuts that could shift costs to beneficiaries and providers.
- Securing sustainable funding for community health centers. Preserving and growing federal funding for community health centers will allow them to continue current operations, while growing to meet the expanding needs of local communities.
- Seeking federal guidance on the Federal Basic Health Option. An option out of the health reform law that is based on our current Basic Health program, our state and others need guidance to fully evaluate its fiscal impact on the state and the new Exchanges.
- Requiring states to implement 12-month continuous eligibility for children and adults in Medicaid and standardizing the collection and reporting of Medicaid quality measures for all enrollees across states.
- Supporting efforts to better integrate and manage care for dual eligible individuals and other high cost populations. In addition to re-authorizing the Medicare Advantage Special Needs Plan (SNP) program, our state is a duals demonstration state and Community Health Plan of Washington and Community Health Network of Washington are participating in the demonstration.
