February 2012
In this Issue
New Resources
Fellowsip Opportunities
Policy Updates
HHS Issues Final Rule on Summary of Benefits and Coverage
On February 9, the U.S. Departments of Health and Human Services, Labor, and Treasury jointly issued the final rule for the Summary of Benefits and Coverage and Uniform Glossary as required under the Affordable Care Act. The rule requires all group and individual health plans to provide uniform and clearly written information on plan benefits, limitations, and costs to current enrollees and applicants shopping for health insurance coverage. Plans will begin providing the Summary of Benefits and Coverage (SBC) on the first day of plan years beginning on or after September 23, 2012.
The Summary of Benefits and Coverage will be accompanied by a glossary of standard medical and insurance terms that plans use to describe health insurance coverage. Notably, this glossary expands the definition of medical necessity beyond "illness, injury, and disease" to include "conditions," which is critical to protecting coverage under this category for people with physical and developmental disabilities.
There are a few areas of concern regarding the final rule: 1) Health plans will only be required to post the Summary of Benefits and Coverage online and provide written notice that it is available online and in paper form (only upon request); 2) The final rule retains language access standards that would leave most limited English proficient individuals without access to translated Summary of Benefits and Coverage or oral assistance; and 3) The final rule eliminates premium information from the Summary of Benefits and Coverage form.
National groups are still discussing how to respond to these issues and influence the development of additional coverage examples as the agencies release further guidance. If you have recommendations or would like to weigh in, please contact us at stateinfo@familiesusa.org.
President’s Budget and the Doc Fix
On February 13, 2012, the President released his annual budget, which requests $76.4 billion for the Health and Human Services Department—a $7 billion increase from last year. In addition, he requested $4.8 billion for the Centers for Medicare and Medicaid Services. More specifically, the budget includes a proposal for a blended Medicaid FMAP starting in 2017, adds a new co-payment for home health services, and increases premiums if seniors choose to have a supplemental Medigap plan.
In addition, Congress reached a deal that extends the payroll tax holiday and unemployment benefits until the end of the year, while preventing a 27 percent cut to Medicare doctors’ pay that would take effect on March 1. However, to pay for the deal, the bill taps $5 billion in funds from the Prevention and Public Health Fund of the Affordable Care Act. The President signed the bill into law on February 22, 2012.
Comments Requested for Domestic Service Labor Standards Rule
On December 27, 2011, the Department of Labor released the proposed rule, Application of the Fair Labor Standards Act to Domestic Service. The proposed rule would extend minimum wage and overtime protection to home care workers, one of the fasting growing segments of the American workforce. Home care workers are currently exempt from these protections. They are poorly paid, one-third are uninsured, and half rely on public assistance.
We depend on home care workers to deliver quality care to seniors and people with disabilities who need long-term care and wish to live in their home rather than in a costly institution. There is currently a chronic shortage of home care workers despite the growing need for this type of care. The proposed rule will address the unequal treatment of home care workers under the Fair Labor Standards Act and will strengthen our health care system. We urge you to comment on the proposed rule. Comments are due by February 27, 2012, and can be submitted online. The Department of Labor needs to hear that this proposed rule has broad support.
Preventive Service Mandate Sparks Action and Accommodation on the Hill
Earlier this month, a full-blown debate erupted over the Administration’s new rule requiring most employers to cover contraception in employee health insurance plans. This rule came as a part of the Affordable Care Act’s mandate of coverage for preventive services, including birth control, with no co-pay or deductible. In a rare floor speech, House Speaker John Boehner vowed Congress would overturn the rule.
On February 10, in response to the debate and pressure from various constituencies, the Administration amended the rule so that it requires insurance companies to pick up the tab for women's contraceptives if religious employers object to paying for them.
Activities in the Field
SEIU Healthcare Minnesota: Using the Exchange to Address Disparities
Advocates at SEIU Healthcare Minnesota have worked tirelessly to make health equity a priority in policy decisions. The Affordable Care Act is providing them, and advocates all over the country, another way to keep health equity in the health care policy discussion—and SEIU Healthcare MN has jumped on the opportunity.
SEIU Healthcare MN spearheaded an effort to inform lawmakers and advocates about how they could use the development of their state insurance exchange to address disparities. At a November 2011 Department of Commerce meeting on the exchange, SEIU Healthcare MN was able to lobby successfully to have a Task Force meeting in January of 2012 dedicated entirely to the subject of disparities.
SEIU and its partners got to work to prepare for the meeting. They did extensive research and coalition work and collaborated with outside partners to come up with the best strategies for addressing equity issues through the exchange. Using this work as a foundation, the group of five Task Force members, representing a Native American tribe, a community clinic serving low-income people of color, the state’s National Alliance on Mental Illness affiliate, a network of African American church leaders, and the SEIU, respectively, put together a wide-ranging set of recommendations, Policy Levers for Addressing Health Disparities through the Exchange. It addresses data collection methods, language access issues, navigator programs, how to best manage partnerships with Accountable Care Organizations, and many other important levers and issue areas.
When it was time for the January Task Force meeting, SEIU Healthcare MN was prepared. A partnership with groups like Take Action Minnesota, ISAIAH Minnesota, the Stair Step Foundation, and others, helped bring out community members to the hearing for public comment. The Task Force presented its recommendations as a fact sheet, and the commissioners of the state Departments of Health and Human Services complemented that presentation with hard data on disparities. The public presence proved significant, resulting in a lively discussion session in which consumers testified about disparities in their communities and voiced their concerns about the current state of equity in Minnesota.
Ultimately, the four-hour meeting resulted in a unanimous motion to consider the effects of all exchange policy decisions on disparities. Moreover, the Minnesota Health Insurance Exchange Advisory Task Force later voted for a consumer-friendly set of recommendations for the exchange, recommending that a majority of the Minnesota exchange board be consumer and small business representatives. While plenty of work remains to be done to ensure that the exchange is consumer friendly, Minnesota advocates have taken big steps toward making sure that the exchange addresses disparities.
While the set of recommendations covers many issue areas and policy levers, SEIU Healthcare Minnesota wants to continue building upon this work by creating new partnerships throughout the nation. Advocates are encouraged to contact Anna Odegaard to collaborate and further this great work.
Upcoming Events
- Five Million Reasons Why Health Care Reform Must Work—Webinar on Children’s Coverage
February 23, 2012
2:00-3:30 PM EST
- 33rd Annual Minority Health Conference—Translational Research: The Road from Efficacy to Equity
February 24, 2012
Chapel Hill, NC
- Webcast: Work and Life Changes Require Health Choices: Know Your Options and Your Rights (in Spanish)
February 29, 2012
1:00-2:30 PM EST
- 5th Annual Health Disparities Conference: Achieving Health Equity through Access, Advocacy, Treatment, and Policy Development
March 6-8, 2012
New Orleans, LA
- 2012 National Health Promotion Summit
April 10-11, 2012
Washington, DC
- 9th Annual National Leadership Summit on Health Disparities/CBC Health Braintrust
April 23-24, 2012
Washington, DC
Requests for Local Publications
Here
at Families USA, we believe that public education is essential to
gaining support for health reform. We are asking that you help us in our
efforts to educate the public about the benefits of the Affordable Care
Act by informing us of local, state, and even national newspapers that
serve your community. We are especially interested in outlets that reach
various racial and ethnic groups and senior citizens. If you have any
questions or would like to submit publications, please contact the Health Equity Department at Families USA at healthequity@familiesusa.org.
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We’d like to hear from you!
If you would like to see your organization or event
highlighted in a future edition of our newsletter, please send us a
brief description of your organization and its activities, as well as
your contact information. We also welcome guest authors for
the Activities in the Field section of the newsletter. This section
provides members of the minority health field with the opportunity to
share their experiences and insights with other advocates. Please send
all correspondence to: healthequity@familiesusa.org.
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