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Many people in correctional institutions have faced barriers obtaining needed health and behavioral health care services in the community either prior to their incarceration or upon reentry followingincarceration. One-third to three-quarters of men booked into jails in ten major cities in 2010 were not covered by any type of health insurance.1 This is largely because of high rates of unemployment and narrow Medicaid eligibility criteria. Unemployment limits access to employer-based health plans and the ability to purchase private insurance or pay health costs out-of-pocket. Additionally, people who have been incarcerated face enduring barriers to employment both because of legal barriers andthe stigma associated with having a felony conviction. Consequently, they also face enduring challenges obtaining employer-based health insurance.2, 3 Medicaid is an alternative for some individuals, but only for those who meet income requirements and who are also either pregnant, have dependent children, or are severely disabled.4The Affordable Care ActThe Affordable Care Act (ACA) signed into law by the President in 2011 potentially can aid individuals who are at risk for incarceration and those who have been incarcerated through provisions that allow states to expand eligibility for Medicaid. The ACA creates new mechanisms for uninsured people to obtain coverage for physical and behavioral health care. First, by 2014 each state must have a health insurance exchange that will act as a regulated health insurance marketplace wherebyuninsured individuals with incomes between 133% and 400% of the federal poverty limit can purchase coverage. Individuals will receive tax credits on a sliding scale to offset the cost of this coverage.5Read on….
Cut through the misinformation that is circulating around the Affordable Care Act and#226;and#128;” and#226;and#128;and#156;Obamacareand#226;and#128;and#157; and#226;and#128;” and make sure you understand what it means to you, your families and your contract. Here is a timeline of some key features of the new law. 2010 No More Lifetime Coverage Limits and#226;and#128;” Insurers can no longer limit the total dollar amount they will pay over a personand#226;and#128;and#153;s lifetime. Key Insurance Reforms and#226;and#128;” Insurance companies can no longer deny coverage to a customer because of a paperwork error or unintentional mistake. Consumers also have new options to appeal an insurance companyand#226;and#128;and#153;s decisions. Coverage Extended to Young Adults and#226;and#128;” Young adults may be covered by their parentsand#226;and#128;and#153; insurance until age 26 if the young adultand#226;and#128;and#153;s employer does not offer insurance. 3.1 million young adults are benefitting. No More Refusing Children Coverage Based on Pre-Existing Conditions and#226;and#128;” This provision will extend to all Americans in 2014. No More Limits for Essential Benefits and#226;and#128;” Insurers may no longer set an annual limit for the amount they will pay for certain benefits, such as hospitalization, maternity, newborn care and prescription drugs, that are considered essential. These maximums will be entirely eliminated in 2014. Closing the and#226;and#128;and#156;Donut Holeand#226;and#128;and#157; and#226;and#128;” Roughly four million seniors who reached this gap in Medicare prescription drug coverage received a tax-free rebate check to help cover expenses. Provides Small Businesses Health Insurance Tax Credits and#226;and#128;” Small businesses are now eligible for the first phase of a new tax credit for employeesand#226;and#128;and#153; health insurance. Four million small businesses are eligible to receive this tax credit. Free Preventative Care and#226;and#128;” All new plans must cover certain preventative services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance. Expanding Coverage for Early Retirees and#226;and#128;” A five billion dollar program is providing needed financial help for employment based plans to continue to provide valuable coverage to people who retire between the ages of 55 and 65, as well as spouses and dependents. 2011 Help for Seniors and#226;and#128;” Seniors who reach the coverage gap will receive a 50 percent discount when buying Medicare Part D covered brand name prescription drugs. The and#226;and#128;and#156;donut holeand#226;and#128;and#157; will ultimately be phased out, keeping millions of seniors from facing rising prescription costs. Certain preventative services, such as wellness visits and personalized prevention plans for seniors on Medicare are now being provided for free. Nearly 33 million seniors are already benefitting. Lowering Healthcare Premiums and#226;and#128;” The law requires that 85 percent of all premium dollars be spent on services or healthcare quality improvement (80 percent for smaller employers). If goals are not met because administrative costs are too high, insurance companies must provide rebates for consumers. This requirement amounts to more than a billion dollars back in the hands of individuals and businesses as a rebate from insurance companies..
On June 28, 2012, the Supreme Court upheld the Patient Protection and Affordable Care Act (ACA) as constitutional, meaning the law is legal and will mostly be implementedas originally written. Many experts predict that the ACA will have a concrete impact on every American individual, but what about communities and community work? As states strive to meet upcoming ACA implementation deadlines, how will place-based initiatives and their constituents be affected? Going beyond Coverage to Improve Community Health is the first in a series of CSSP Issue Briefs that examine how place-based initiatives can harness ACA resources and programs to maximize community health. Some of the new or enhanced programs, initiatives and funding streams authorized by the ACA and highlighted in CSSPand#226;and#128;and#153;s Issue Brief are described below: Community Transformation Grants (CTG) are intended to combat health disparities and chronic illness by empowering local communities to recognize and address social determinants of health outcomes. Grantees will focus on reducing health disparities and chronic disease rates through targeted disease prevention and health promotion initiatives. CTG is dedicated to supporting and expanding evidence-based strategies. Roughly $103 million CTG funds have been awarded thus far. Grantees for the small communities program will be announced in September 2012. See here for more information about CTG.The National Prevention, Health Promotion and Public Health Council, an inter-agency coalition of 17 federal departments, models the cross-sector collaboration that many place-based initiatives also operationalize. The Counciland#226;and#128;and#153;s first report, National Prevention Strategy: Americaand#226;and#128;and#153;s Plan for Better Health and Wellness, highlights four strategic directions for prevention-oriented work, listed below, and serves as a guide for how communities can implement prevention strategies.Strategic Directions for Prevention-Oriented Work: Health and safe community environmentClinical and community preventive servicesEmpowered peopleElimination of health disparities The National Prevention Strategy has also defined seven priorities: Tobacco Free LivingPreventing Drug Abuse and Excessive Alcohol UseHealth EatingActive LivingInjury and Violence Free LivingReproductive and Sexual HealthMental and Emotional Well-BeingIn order to maintain their tax-exempt status, non-profit hospitals will now be required to conduct a periodic community health needs assessmentand demonstrate concrete action to address identified needs. The needs assessment process must be public knowledge and will provide opportunities for place-based initiatives and community organizations to partner with local hospitals. The ACA enhances the evidence-based, two-generation Maternal, Infant and Child Home Visiting Program. ACA funding to states and native tribes will be partially categorical and partially competitive. As part of the application process, states must conduct a needs assessment, identify at-risk communities and assess home visiting programs already operating in the state. While this yearand#226;and#128;and#153;s funds have already been allocated, stay tuned for the $400 million that will be available through this program in FY 2013. The ACA requires every state to launch a culturally competent and linguistically diverse Navigator program to assist individuals/ families enrolling in health insurance through their state Health Insurance Exchange (and#226;and#128;and#156;a new and#226;and#128;and#152;health insurance marketplaceand#226;and#128;and#153; created by the ACA that is designed to offer a range of affordable, quality insurance coverage options to individuals and familiesand#226;and#128;and#157;). Navigators are tasked with encouraging health insurance enrollment and ensuring that consumers have accurate and full information about their options. Through the new Community Health Center Trust Fund, the ACA will support federally qualified health centers (FQHCs) in an effort to bring them to greater scale and to encourage development of new FQHCs in medically underserved communities. FQHCs already have a measurable impact, currently serving roughly 20 million uninsured patients. The first round of Community Health Center Trust Fund grantees was announcedin May 2012. The School-based Health Center Capital Programwill fund capital improvements to school-based health centers (SBHCs), prioritizing those schools with high Medicaid- and CHIP-eligible student bodies. SBHCs often serve studentsand#226;and#128;and#153; families and neighbors in addition to the students themselves and present an opportunity to link clinical health to other community or school initiatives. New networks known as Accountable Care Organizations (ACOs)will provide targeted, coordinated, continuous care, including primary and specialty medicine. ACOs will structure payment based on outcomes, rather than the amount of services provided and will be closely linked to the communities served.For more information and a full list of ACA opportunities applicable to place-based initiatives, see CSSPand#226;and#128;and#153;s Issue Brief: Going beyond Coverage to Improve Community Health. .
Source:
http://crimbrary.blogspot.com/2012/09/the-affordable-care-act-implications.html
http://charlieaverill.blogspot.com/2012/09/the-affordable-care-act-how-does-it_17.html
http://financing-community-change.blogspot.com/2012/09/the-affordable-care-act-and-place-based.html
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