| The latest news from and for state health care advocates |
September 2010 |
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In each edition, we'll feature an action, victory, campaign, or interesting tactic shared by a state advocate. Send us your updates. |
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In This Issue:
Buzz around the States
North Carolina and Colorado win refunds for consumers from insurers for unfair rate hikes.
UHCAN Ohio hosted a conference call with HHS Regional Director Cristal Thomas.
NJ Citizen Action, NJ for Health Care, NJPIRG Student Chapters, and the NJ Main Street rally at Rutgers University to celebrate September 23 provisions.
Tennessee Health Care Campaign names Beth Uselton, beloved and long-time friend to many, as the new Executive Director; Tony Garr steps down in a transition toward retirement.
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States in Focus
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By passing these bills early, California is showing that it will not only comply with the Affordable Care Act, but it will go beyond it where it can. This legislation puts California in a great place to optimize new benefits for consumers and to make sure it is ready to go on day one to take advantage of all the federal funds available to the state. According to Health Access Executive Director Anthony Wright, these bills are just the beginning of the steps that need to be taken to ensure Californians get all the benefits they are entitled to under the Affordable Care Act.
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California Creates a “Glide Path” to 2014
The California state legislature recently took historic steps to get the implementation of the Affordable Care Act (ACA) moving at the state level. In late August, the California state legislature passed over a dozen bills to further consumer protections in the private market. The state is receiving the most attention for the two bills that passed that would establish and set up the governance for a California-run health insurance exchange: California is the first state in the nation to do this. Health Access California played a key role in moving this legislation forward. Executive Director, Anthony Wright, classified the effort to act quickly on this legislation as a strategic move.
Anthony described a concerted effort to implement and improve the health care law in California. Because of past attempts to reform in California’s health system, stakeholders and legislators already held informed opinions on this issue. Health Access and allies moved quickly to seek out support for various provisions in the ACA, engage a range of stakeholders where possible, and push the state to act early on health care implementation. Anthony credits their recent victory to a few different factors. Framing the health care legislation in the context of the new federal law made the legislative process much smoother. Anthony and others argued that by passing these bills, California would be complying with federal law. The passage of federal reform allows the state to institute these reforms with federal dollars, a key factor due to the current dramatic budget crisis.
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The strategy of passing bills now was to start the transition of the California insurance market toward mandated changes early, thereby avoiding any shock to the market. Anthony says that the bills passed in the California legislature created a “glide path” from now until 2014, so that a smooth transition can occur over the next few years for consumers and the market. To get this early start on a state-run exchange, they passed two companion bills. One sets up an exchange and the other establishes its governance. These bills will give the state time to get a working exchange ready to go on day one. And this initiative to get things moving also puts California in the position to be a leader on state exchanges as other states set up their own exchanges and look to California's legislation as a model.
Advocates and legislators realized that within this new exchange there would be many new regulations that insurers would need to comply with. One of the bills asks plans to categorize benefit packages to exchange standards now. With early implementation, insurers will have time to get their plans up to par and allow consumers to get accustomed to the new terminology.
Some of the bills passed went beyond the federal regulations to provide more protections for consumers. For example, one bill requires that insurers not only need to accept children with pre-existing conditions, but they are also not allowed to charge sick children more than twice the amount for the plans they offer healthy children, eliminating the cost difference that would have existed until full federal implementation in 2014.
Although these bills passed both the Senate and the Assembly in California, they are still waiting for the governor’s signature. Governor Schwarzenegger has until the end of this week to sign these bills into law. Health Access and the HCAN coalition have continued to engage consumers to urge him to take this next step to move implementation forward. For more information on Health Access and the California health care legislation visit their website and blog.
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State groups teamed up with universities and colleges, student PIRGs, the Young Invincibles, and other key partners to get the word out about young adult coverage. The Department of Health and Human Services was especially committed to using this date as an education tool and sent surrogates to speaking events across the country. Continuing to use these partners will be essential moving forward. September 23 is the beginning, not the end!
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Creative Strategies brought Media Attention to the September 23 Anniversary
September 23 was a big day for the consumer health advocacy community. The day marked the six-month anniversary of the signing of the Affordable Care Act. On this day, some of the many consumer protections in the law took effect. These protections are known as the Patients’ Bill of Rights.
Students at Towson University in Maryland tout young adult coverage provision. |
Surgeon General Regina Benjamin |
Kathleen Stoll, Deputy Director of Families USA, hit the road to talk about September 23 provisions in Philadelphia. |
HHS Regional Director, Cristal Thomas, appeared at September 23 events. Her counterparts in other regions also helped groups get coverage across the country. |
This date was a special opportunity to generate media coverage around the Affordable Care Act (ACA), educate the public, and set a positive public discourse about ACA implementation and its impact. State organizations came out in full force last week to make sure the week was a success. With some of the most popular provisions of the law taking effect on the 23rd, including a ban on pre-existing conditions for kids and the extension of young adult coverage to age 26, many groups chose to focus on issues that would grab the media’s attention and energize the grassroots.
Maryland: Bring in the Hot Shots. The Maryland Citizen Health Initiative (MCHI) hosted events at two universities in order to focus on the young adult provision. The U.S. Surgeon General Regina Benjamin and Regional HHS Director Joanne Grossi were also able to participate in these events. Through these partnerships, the group was able to receive excellent media coverage that not only discussed the young adult provisions, but also went into the other consumer protections that started on September 23.
North Carolina: Practice Your Quips. North Carolina Justice Center’s Adam Searing was quoted in an article focused on rural health comparing health reform to an oil tanker.
Wisconsin: Engage Key State Players. Citizen Action of Wisconsin organized several events around the state and included state lawmakers—not only to gain media coverage, but also to highlight state efforts to move implementation forward.
Colorado and Wyoming: Use the Op-Ed Page. Dede de Percin, executive director of the Colorado Consumer Health Initiative, published an op-ed in the Denver Post about new benefits of the Affordable Care Act. Barb Rea, of the Equality State Policy Center in Wyoming, published an op-ed in the only statewide paper that focused on September 23 benefits and called for Wyoming officials to move forward on implementation at the state level.
Pennsylvania: Be Persistent. After learning of President Obama’s visit to the city to do an event at virtually the same time as their health care event, the Pennsylvania Health Access Network (PHAN) and Philadelphia Unemployment Project could have easily abandoned all hopes to get coverage on their event. But the groups kept at it, built a crowd, and included key speakers, including the Regional HHS Director, representatives from the National Physicians Alliance, and Families USA staff, to talk about important September 23 provisions. And sure enough the media paid attention. PHAN went on to do 11 more events across the state.
Illinois: Get out across the State. The Campaign for Better Health Care maximized media coverage by spreading out across the state. By putting on campus and other events across the state, they were able to generate media in several different media markets and broadened their impact. Read this article from Champaign and this news story from the Quad Cities.
By reading the stories linked in the above paragraphs, you can see the main feature of almost all of the media coverage is consumer stories. Time and time again, we hear that stories are not only the key to getting media coverage but also paramount to reaching consumers about the benefits of the Affordable Care Act. Whether it is through events, articles, videos, or organizing, enhancing your ability to tell stories will help you reach your community and educate people about this law.
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Nebraska Appleseed Executive Director Becky Gould never underestimated the power of state law and the effect it can have on a particular constituency. As an advocate, there is great opportunity to counteract the policies of state agencies. A policy or practice might be permitted under federal law, and it is important to find out if your state takes up the option. It is equally important to figure out how different options shape policymaking in your state, because laws will have different effects on different populations.
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Huge Victory for Medicaid Advocates in Nebraska
Nebraska Appleseed succeeded in a class action lawsuit, Davio v. HHS, to restore Medicaid health care benefits to low-income parents who were unlawfully dropped from the program by the Nebraska Department of Health and Human Services. This is a major victory for more than 6,000 low-income parents like Jennifer Davio, who was the first to bring light to this issue. She was a Medicaid beneficiary who was dropped by the program.
Jennifer Davio approached Nebraska Appleseed because she had chronic health conditions with no access to care. Nebraska Appleseed staff attorneys realized Jennifer’s problem was due to state sanctions for the Employment First Program, the welfare-to-work program of Nebraska’s Aid to Dependent Children cash assistance program. As a participant in this program, Davio lost her Medicaid coverage. When Nebraska Appleseed researched her problem, they soon discovered this problem was affecting 400 low-income parents each month. Nebraskan parents on the Employment First Program were receiving a harsher sanction than allowed by law. Each month, participants would lose cash assistance as well as access to Medicaid. In some cases, coverage would lapse for up to 12 months.
After identifying the problem, Nebraska Appleseed took the issue to the courts and won. Staff Attorney, James Goddard explains, “The purpose of the Employment First Program is to help people become economically independent as quickly as possible. Medicaid coverage helps to support and stabilize families working their way to self sufficiency. The Legislature specifically set the penalty failing to comply with Employment First and that penalty does not include removing Medicaid benefits. The Nebraska Supreme Court found that HHS cannot decide on its own to increase the penalty set by the legislature.”
Beat of the Month
Groups across the country utilized key partners on September 23. This month’s Beat promotes that same theory: Use Somebody by Kings of Leon.
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Families USA developed a blog series in partnership with several national and state-based organizations for all the September 23 provisions in the Patients’ Bill of Rights. This blog series is an excellent way to share information about the September 23 provisions, and we encourage you to cross-post them. Find the blogs on our Stand Up for Health Care website: http://www.standupforhealthcare.org/learn-more/quick-facts/9-23.
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New Resources from Families USA
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