Families USA: Publications

Publications on the new health law developed by Families USA.

General

A Closer Look: The Supreme Court's Health Care Decision explains what was at stake in the case against the Affordable Care Act, how the Supreme Court ruled, and the impact of the ruling on the law. 4 pp. (August 2012)

Being a Woman Just Got a Little Easier: How the Affordable Care Act Benefits Women outlines what women stand to gain under the Affordable Care Act. 8 pp. (July 2012)

Implementing the Patient Protection and Affordable Care Act: A 2012 State To-Do List for Exchanges, Private Coverage, and Medicaid gives state advocates an in-depth blueprint for action in 2012, outlining issues to start thinking about and tasks that deserve immediate attention. 10 pp. (February 2012)

Talking Turkey is a short piece that is designed to help people talk about the benefits of the Affordable Care Act in an informal way, even at the Thanksgiving table. 2 pp. (November 2011)

The Bottom Line: How the Affordable Care Act Helps America's Families shows the net financial effects of the Affordable Care Act on family budgets. We found that lower- and middle-income families, both uninsured and insured, will be financial winners. | State Reports 18 pp. (October 2011)

States Are Benefitting from Provisions of the Affordable Care Act lists the number of people in each state who are already benefiting from each of five provisions. The provisions include measures that are helping small businesses provide coverage to their workers, helping seniors get free preventive care, and protecting children with pre-existing conditions. 3 pp. (March 2011) | Table

"Defunding" the Affordable Care Act: Guilty of a Double Standard discusses the important new rights and benefits that many in the House of Representatives are planning to take away from millions of Americans but intend to keep for themselves (at taxpayer expense) when they vote to defund or repeal the Affordable Care Act. The piece lists 14 rights and benefits. 8 pp. (February 2011)

Sharing Across the States: Strategies for Public Education is a guide for state advocates about how to educate the public about the new health care law. This guide discusses community forums and Train-the-Trainer programs and gives examples of how state groups across the country have used these public education models to get information to their communities. 16 pp. (September 2010)

The Next 90 Days: A State Advocate's To-Do List provides an overview of the provisions to be implemented in the next 90 days, including coverage for dependents up to age 26, the appeals process, the prohibition of rescissions, and other protections, as well as follow-up on other important issues for advocates. | pdf version(Families USA, June 2010)

How Health Reform Helps the States are state-specific one-page fact sheets that look at the many benefits that health reform will bring to each state, including cracking down on insurance company abuses, ending runaway premiums, and providing financial security. 1 p. (May 2010)

Building Blocks of Health Reform: The Social Security and Medicare Examples To those who say the newly enacted health reform legislation does too little or is too incremental, take a look at the history of Social Security and Medicare. l Building Blocks with a focus on minority seniors 2 pp. (April 2010)

Efforts to Halt Health Reform: Playing Politics with Our Health counters the misinformation that is being spread by opponents of reform, particularly regarding the individual responsibility requirement, and presents the facts about their efforts to block reform. 2 pp. (April 2010)

The First 90 Days: A State Advocate's To-Do List provides an overview of the provisions to be implemented in the first 90 days, including coverage for uninsured people with pre-existing conditions, grants for consumer assistance offices, and Medicaid and CHIP maintenance of effort requirements. | pdf version 8 pp. (April 2010)

A Summary of the New Health Reform Law describes the major changes in health coverage that health reform will bring, including Medicaid and CHIP coverage, the affordability provisions, the exchanges, individual and employer responsibility requirements, improvements in private market coverage, and changes to Medicare and long-term services. 21 pp. (April 2010)

What Will the New Health Reform Law Do in the First Year? discusses how health reform will help people with pre-existing conditions, young adults, people on Medicare, small businesses, community health centers, and others in its first year. 3 pp. (April 2010)

Help Is on the Way: 12 Reasons to Embrace Health Reform discusses key improvements in the new health reform law, including clamping down on insurance company abuses, offering tax credits to small businesses, expanding Medicaid, and improving Medicare. 8 pp. (March 2010)

Children

Simplifying Enrollment and Eligibility with Modified Adjusted Gross Income (MAGI) explains the benefits of aligning income calculation rules in Medicaid, CHIP, premium tax credits, and Basic Health programs (where applicable) through MAGI. 6 pp. (October 2011)

The Basic Health Option: Will It Work for Low-Income Consumers? provides a framework for advocates to think about whether this option, created by the health care law, will work for their state. It covers program basics, discusses the problems it might address, and raises key issues that can affect the direction such a program might take. 12 pp. (July 2011)

How States Are Making Sure Coverage Is Available to Children notes that, under health reform, insurers are required to accept children regardless of any pre-existing conditions in all group plans and in newly sold individual plans, and it examines what several states are doing to make sure that child-only policies are still available. 7 pp. (October 2010)

How Health Reform Helps Low-Income Children discusses how health reform sustains Medicaid and CHIP funding, enhances enrollment in the programs, further expands children's coverage, and increases their health care benefits. 4 pp. (July 2010)

Maintenance of Effort Requirements under Health Reform discusses how health reform changes the maintenance of effort requirements that are already in place for state Medicaid and CHIP programs. 2 pp. (March 2010)

Enrollment

Applying for Health Coverage Online: The Affordable Care Act Helps Americans Enroll discusses provisions in the Affordable Care Act that call for states to have one streamlined online application that allows consumers to apply for Medicaid, CHIP, and premiums credits available to purchase health coverage in state exchanges. The brief also examines where states are now in the implementation of an online application process. 20 pp. (March 2011)

Express Lane Eligibility: Early State Experiences and Lessons for Health Reform reviews the early experiences of four states under the Children's Health Insurance Program Reauthorization Act (CHIPRA) and how those experiences can be instructive as states move to implement health reform. The states are Alabama, Iowa, Louisiana, and New Jersey. 19 pp. (January 2011)

Enrollment Policy Provisions in the Patient Protection and Affordable Care Act outlines the provisions that apply to Medicaid, CHIP, and the exchanges, and those that encourage coordination of enrollment procedures among the three programs. 6 pp. (Updated December 2010)

Exchanges

Filling in Gaps in Consumer Assistance: How Exchanges Can Use Assisters explains the key differences between navigator and assister programs and how in-person assistance can function in the different types of exchanges. It also recommends actions advocates can take. 9 pp. (November 2012)

The District of Columbia Health Benefits Exchange Proposal provides answers to questions about how the exchange will work and how it will help District residents and small businesses obtain affordable health coverage. 5 pp. (October 2012)

Exchange Implementation: To Partner or Not to Partner? lists questions to consider in determining whether a partnership exchange would be in the best interest of consumers and small businesses in states that are unlikely to establish state-based exchanges. 6 pp. (October 2012)

State Responsibilities in a Partnership Exchange explains the options for states that choose to implement a partnership exchange, and it describes the functions that partner states will need to perform. 7 pp. (October 2012)

Brokers and Agents and Health Insurance Exchanges discusses how brokers and agents will interact with the new health insurance exchanges opening in states in 2014 and highlights issues that advocates and states may want to think about. 16 pp. (September 2012)

Why We Need a Health Insurance Exchange is a one-page handout that cites several reasons why consumers will benefit from the new exchanges, including competition, affordability, and quality. Advocates can modify this version to fit their needs. (June 2011)

Obtaining Exchange Funding and Achieving Consumer-Friendly Outcomes: A State "To Do" List outlines tasks states need to complete to obtain federal exchange grants and move ahead with implementation of an exchange. (May 2011)

Options for Governance and Oversight highlights key issues to consider in the creation of a successful, consumer-friendly governance structure, including where the exchange should be housed, good governance, and duties of a board. (April 2011)

Selecting Plans to Participate in an Exchange: A State Guide is designed to help stakeholders understand what's involved and how the process can be structured in the best interest of state residents. It reviews the federal minimum standards, discusses additional elements to consider, and offers specific state examples. (February 2011)

Implementing Health Insurance Exchanges: A Guide to State Activities and Choices describes the requirements in the Affordable Care Act that exchanges must meet and outlines key questions that states and consumer advocates will need to consider as the exchanges are designed. (October 2010)

Building an Effective State Exchange offers 15 benchmarks to guide advocates and legislators as they develop the new health care exchanges that are required by the Affordable Care Act. Advocates are free to take this document and adapt it to the needs of their states. 3 pp. (December 2010)

Health Equity

How Health Reform Helps Communities of Color is a series of state-based fact sheets that discuss how provisions in the Affordable Care Act--both those for the general public and those specifically designed to eliminate health disparities--help communities of color in each state. 7 pp. (September-October 2010)

How Health Reform Helps . . . is a series of fact sheets that highlight how the new health reform law will help America's communities of color by expanding coverage, increasing funding for community health centers, and providing grants for workforce diversity. 4 pp. (September 2010) African Americans l American Indians and Native Alaskans l Asian Americans l Latinos l Native Hawaiians and Other Pacific Islanders

Moving toward Health Equity: Health Reform Creates a Foundation for Eliminating Disparities summarizes provisions that will expand access to care through Medicaid and community health centers, and that address health disparities by promoting language access, increasing workforce diversity, and reauthorizing the Indian Health Care Improvement Act. 7 pp. (May 2010)

Health Reform: Help for American Indians and Alaska Natives discusses changes made by the new health reform law, including the overdue reauthorization of the Indian Health Care Improvement Act, and explains how these changes will benefit these two groups. 9 pp. (May 2010)

Long-Term Services and Supports

The Health Care Law: Good News for Caregivers discusses how the health care law will help build the long-term care workforce, encourage states to expand home- and community-based services in Medicaid, improve resources for caregivers, and expand protections for people in long-term care facilities. 7 pp. | The Affordable Care Act: Provisions that Will Help Caregivers 6 pp. (March 2011)

Protecting Seniors and People with Disabilities: Why It Is Important to Preserve the Maintenance of Effort Requirement in the Affordable Care Act discusses how stripping the maintenance of effort requirement from the ACA will have negative consequences for the many people who depend on Medicaid by allowing states to change eligibility requirements. 4 pp. (February 2011) | State Reports

In Perspective: Better Safety and Quality for Seniors and People with Disabilities discusses the Elder Justice Act, the Patient Safety and Abuse Prevention Act, and the Nursing Home Transparency and Improvement Act, three sections in the Affordable Care Act that will bring historic improvements to the quality and safety of long-term care and result in the most comprehensive federal effort ever to fight elder abuse. 3 pp. (October 2010)

In Perspective: Help for Those Who Need Long-Term Care describes how the Affordable Care Act will help more people stay in their homes or the community (rather than an institution) and why this help is needed. 3 pp. (September 2010)

Health Reform Provisions that Expand Access to Home- and Community-Based Services (HCBS) briefly outlines key provisions, including the State Balancing Incentive Payments Program, the Community First Choice Option, and Changes to the Medicaid 1915(i) option. 2 pp. (September 2010)

Long-Term Services: Provisions in the New Health Reform Law outlines key provisions that expand coverage, including the Community First Choice Option, the State Balancing Incentives Payment Program, the Community Living Assistance Services and Supports (CLASS) Program, and extending the Money Follows the Person Medicaid demonstration project. 10 pp. (May 2010)

Helping People with Long-Term Health Care Needs: Improving Access to Home- and Community-Based Services in Medicaid discusses how health reform gives states incentives to strengthen home- and community-based services in Medicaid. 4 pp. (Updated April 2010)

Helping People with Long-Term Health Care Needs: An Insurance Program to Help People Afford Long-Term Services and Supports discusses the Community Living Assistance for Services and Supports (CLASS) program, a new, voluntary, public long-term services insurance program that is part of health reform. 2 pp. (Updated April 2010)

Medicaid

Designing Consumer-Friendly Health Homes discusses six key decisions that states need to make when they set up Health Homes. It also explains the challenges that state advocates should address to ensure that Health Homes improve care for Medicaid beneficiaries. 22 pp. (January 2013)

Health Homes in Medicaid: Challenges and Opportunities for Advocates defines Health Homes and discusses their potential to improve care for vulnerable patients, the role that advocates can play, and challenges that states and advocates will face. It includes a chart that summarizes key details of Health Homes in IA, MO, NC, NY, OH, OR, and RI. 19 pp. (November 2012)

The Medicaid Upgrade: Required and Optional Medicaid Eligibility Changes for 2014 is a chart that outlines changes that states are required to make and changes that they have the option to pursue in order to make the eligibility process more streamlined and consumer-friendly. 4 pp. (November 2012)

The Supreme Court Decision: What it Means for Medicaid gives an in-depth look at the Court's ruling on Medicaid and what advocates can do to make sure their state expands coverage. (August 2012)

Investing in Medicaid Contributes to Better Education explains how Medicaid coverage can actually help children in ways that help them perform better at school. (August 2012)

Making the Most of Accountable Care Organizations (ACOs): What Advocates Need to Know provides an overview of ACOs; the promise they hold; and how they could change Medicare, Medicaid, and the health care landscape. It also identifies key challenges in their development and suggests how advocates can get involved in ways that benefit patients. 12 pp. (Updated February 2012)

Putting the Accountability in Accountable Care Organizations: Payment and Quality Measurements examines some of the challenges that advocates will face when working with policy makers, insurers, and providers to develop mechanisms that ensure that beneficiaries receive high-quality care at a lower cost. 9 pp. | Determining Shared Savings or Losses 6 pp. (January 2012)

Designing Consumer-Friendly Beneficiary Assignment and Notification Processes for Accountable Care Organizations discusses the challenges advocates will face when developing these processes, and it recommends certain notification requirements and beneficiary protections. 8 pp. (January 2012)

To Build a Strong Affordable Care Act, Protect Medicaid explains that Medicaid is the foundation for health reform and briefly discusses the proposals that could damage Medicaid. Those working to implement health reform need to understand how threats to Medicaid could undermine their work. 7 pp. (September 2011)

A Guide for State Advocates: State Demonstrations to Integrate Medicare and Medicaid explains the requirements for demonstrations, discusses possible models of integration, and provides guidance to advocates on how to get involved in the planning process. 10 pp. (April 2011)

House Republicans Propose to Slash Funding for Medicaid, Medicare, and Other Health Coverage Programs takes a closer look at how the recent budget proposal would harm seniors, children, and state economies, including state-specific numbers. 19 pp. (April 2011)

Medicaid and the Affordable Care Act: Reframing the Debate addresses concerns about the effect of the Medicaid expansion on state budgets and outlines the many benefits that the Medicaid expansion will bring to states and the uninsured. 4 pp. (October 2010)

Early Medicaid Expansions under Health Reform discusses how states can expand their Medicaid programs under a state plan amendment prior to 2014-and why they should. 4 pp. (April 2010)

Medicare

This series of fact sheets discusses how Medicare is taking an important step forward, thanks to the Affordable Care Act, to provide more preventive and wellness care to beneficiaries. Medicare is now providing free preventive care and a free annual wellness visit that will help beneficiaries prevent illness in the first place. These fact sheets discuss how beneficiaries can take advantage of these benefits and how advocates can answer questions and resolve problems. (Updated February 2012)

For consumers: Medicare's Preventive Care Benefit: What It Means for You (5 pp.) l Medicare's Annual Wellness Visit: What It Means for You (4 pp.)

For advocates: An Advocate's Guide to the Preventive Services Benefit in Medicare (6 pp.) l An Advocate's Guide to the Annual Wellness Visit Benefit in Medicare (4 pp.)

Helping People with Medicare discusses how health reform will help make Medicare more affordable for seniors and people with disabilities, improve health care quality for enrollees, and make the program more financially secure. (Updated September 2011)

An Advocate's Guide to the Medicare Coverage Gap Discount Program is a troubleshooting guide for advocates who assist beneficiaries with navigating the new program, including answers to frequently asked questions. 6 pp. (December 2010)

Help in the Doughnut Hole: the Medicare Coverage Gap Discount Program discusses the basics of this program, including the 2010 rebate checks, the 2011 discounts, changes in drug availability, and dispute resolution. 4 pp. (December 2010)

Welcome to the Medicare Prescription Drug Benefit for 2011 is an updated illustration that reflects improvements made by the Affordable Care Act that will lessen the amount enrollees will pay when they fall into the "doughnut hole." (November 2010)

In Perspective: Lower Costs, Better Care - Medicare Cost Savings in the Affordable Care Act discusses how the Affordable Care Act will make Medicare work more efficiently by improving the way providers deliver care, modernizing how Medicare pays for services, and eliminating waste, fraud, and abuse in the system. These changes will also reduce costs, make the program more sustainable, and allow for better benefits for those who depend on Medicare. 10 pp. | Talking Points (September 2010)

Patients' Rights and Protections

The Affordable Care Act: Patients' Bill of Rights and Other Protections is a compilation of all of our fact sheets to date on consumer rights and protections. 31 pp. (April 2011)

A series of fact sheets on the Patients' Bill of Rights and other consumer protections in the Affordable Care Act that took effect on September 23. (September 2010)

Grandfathered Plans under the Patient Protection and Affordable Care Act discusses health plans that existed on the date that health reform was enacted and are therefore exempt from some provisions of the law. It explains the requirements health plans must meet to maintain grandfathered status and outlines which protections in the health reform law apply to such plans and which do not. 6 pp. (Updated December 2010)

Health Coverage for Young Adults: Health Reform Will Soon Allow You to Stay on Your Parent's Health Plan is a fact sheet aimed at young adults (and their parents) that is designed to answer important questions about this new opportunity to keep or obtain health coverage for young adults up to age 26. 6 pp. (May 2010)

Health Reform: Help for Americans with Pre-Existing Conditions discusses how, under health reform, no one will be denied coverage, charged a higher premium, or sold a policy that excludes coverage of essential benefits because of pre-existing conditions. The report presents the number of Americans with diagnosed pre-existing conditions who, absent reform, would be at risk of being denied coverage in the individual insurance market. It breaks down this number by age, income, and race. 25 pp. | State Reports (May 2010)

Tax Credits

Good Business Sense: The Small Business Health Care Tax Credit in the Affordable Care Act includes national and state-level estimates of how many small businesses will be eligible and how much the credits will be worth. Also includes data on how many workers could benefit. (Done in conjunction with Small Business Majority, May 2012)

Lower Taxes, Lower Premiums: The New Health Insurance Tax Credit examines how this tax credit will help both insured and uninsured Americans. It provides data on the number of people eligible, the total dollars available, and on how it will help working families in particular. | State Reports (September 2010)

A Helping Hand for Small Businesses: Health Insurance Tax Credits analyzes the health reform provision that provides tax credits to small employers to help them buy health coverage for their workers. This report, which was commissioned along with Small Business Majority, provides national and state-level data on the number of small businesses eligible for the credit in 2010, as well as the number eligible for the maximum tax credit. 10 pp. (July 2010)