Category Archives: Health Care

Expert Q&A on Employee Benefits After the US Supreme Court’s DOMA Ruling

Source: Howard D. Bye-Torre, Practical Law The Journal, Vol. 5 no. 8, October 2013
(subscription required)

An expert Q&A with Howard Bye-Torre of Stoel Rives LLP on the implications of the US Supreme Court’s decision in United States v. Windsor and subsequent guidance for employers who sponsor retirement and health plans for their employees and family members.

Navigators and In-Person Assisters: Resource Center

Source: Families USA, 2013

The new marketplaces are now open for consumers to begin applying for health insurance. This support center provides information about state enrollment assistance programs and resources to help provide consumers with the information they need to get enrolled. Consumers can use the “Find Local Help” tool to find out how to get enrollment assistance in their state. Apply to become a Champion for Coverage, if your organization is interested in joining more than 900 organizations nationwide to help Americans without affordable insurance learn how to get coverage through the marketplace. …

Medicaid Alternative Benefit Plans: What States Should Consider When Designing Coverage for the Expansion Population and the Role for Advocates

Source: Dee Mahan, Amy Traver, Families USA, Issue Brief, November 2013

Alternative Benefit Plans offer states a great deal of flexibility, as well as an opportunity to provide people in the expansion population with comprehensive coverage that meets their health care needs. This brief looks at the issues that states should consider as they design a benefit plan for people who will be newly eligible
for Medicaid. It also outlines opportunities where consumer advocates can engage in the process, both during the initial benefit design
and when making improvements to the plan….

Workplace Wellness Programs Study – Final Report

Source: Soeren Mattke, Hangsheng Liu, John Caloyeras, Christina Y. Huang, Kristin R. Van Busum, Dmitry Khodyakov, Victoria Shier, RAND, Research Reports, RR-254, 2013

From the abstract:
The report investigates the characteristics of workplace wellness programs, their prevalence, their impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. The authors employ four data collection and analysis streams: a review of the scientific and trade literature, a national survey of employers, a longitudinal analysis of medical claims and wellness program data from a sample of employers, and five case studies of existing wellness programs in a diverse set of employers to gauge the effectiveness of wellness programs and employees’ and employers’ experiences.
See also:
The Skinny on Workplace Wellness Programs
Source: Soeren Mattke, Hangsheng Liu, John Caloyeras, Christina Y. Huang, Kristin R. Van Busum, Dmitry Khodyakov, Victoria Shier, RAND, Research Briefs, RB-9717, 2013

Health Advocate: Due Process

Source: Sarah Somers and Kim Lewis, National Health Law Program, Health Advocate, Vol. 19, November 2013

While almost everyone has heard about the new opportunities that the Affordable Care Act (ACA) brings to millions of uninsured Americans to obtain health coverage, many are not aware of the rights and protections that the newly insured will have protecting
them against wrongful denials of coverage. These rights stem from the Fourteenth Amendment of the U.S. Constitution, which prohibits governmental deprivations of “life, liberty, or property, without due process of law.” These rights are well-established for Medicaid beneficiaries and applicants. Now, federal regulations explicitly extend these rights to individuals seeking insurance coverage and other benefits through the newly created Health Insurance Exchanges. This issue of the Health Advocate describes the due process requirements governing the Exchanges and changes made to Medicaid notice and hearing regulations intended to coordinate and align the Exchange and Medicaid requirements.

Affordable Care Act of 2010: Creating Job Opportunites for Racially and Ethnically Diverse Populations

Source: Bianca Forgner, Joanne Spetz, Jount Center for Political and Economic Studies, November 2013

The health care industry has been an engine of job growth, and the Affordable Care Act of 2010 (ACA) is expected to stimulate further growth. Over the next decade, the health care sector could add 4.6 million jobs, representing a 31% increase from current employment. New job opportunities from entry-level positions to highly trained professions are expected to emerge in the industry.

In this report, we present an inventory of health care jobs occupied by people of color, and the changes in occupation mix over time. We then estimate job growth in the health care industry and present potential job opportunities for people of color. If we assume the current racial and ethnic distribution of the health care workforce persists, we would expect that in the future at least one-third of the total health care workforce will comprise people of color. This estimate is almost certainly lower than what will occur, because many people of color — especially Blacks and Hispanics — are in occupations that are among the fastest growing in the U.S.

The goal of this report is to provide knowledge that can help foster and enhance racial/ethnic diversity of the health care workforce.

The Impact of Medicaid on Labor Force Activity and Program Participation: Evidence from the Oregon Health Insurance Experiment

Source: Katherine Baicker, Amy Finkelstein, Jae Song, Sarah Taubman, NBER Working Paper No. 19547, October 2013

From the abstract:
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. We use this randomized design and 2009 administrative data to evaluate the effect of Medicaid on labor market outcomes and participation in other social safety net programs. We find no significant effect of Medicaid on employment or earnings: our 95 percent confidence intervals allow us to reject that Medicaid causes a decline in employment of more than 4.4 percentage points, or an increase of more than 1.2 percentage points. We find that Medicaid increases receipt of food stamps, but has little, if any, impact on receipt of other government benefits, including SSDI.

Under Pressure: An Update on Restrictive State Insurance Marketplace Consumer Assistance Laws

Source: Justin Giovannelli, Kevin Lucia, and Sarah Dash, Commonwealth Fund blog, October 31, 2013

To help consumers enroll in the recently opened health insurance marketplaces, the Affordable Care Act created outreach and consumer assistance positions such as “navigators,” in-person assisters, and certified application counselors. Though they are subject to uniform federal standards, in practice, these programs range widely from state to state, because of the adoption of laws and regulations in many states that make it difficult for navigators to perform their jobs, as well as differences in funding for consumer assistance for different types of marketplaces. In this post, the first of a two part-series, we will examine the new restrictions; our next post will look at the how the limited funding for outreach and education for federally facilitated marketplaces, compared with state-run or state partnership marketplaces, may be limiting consumer outreach efforts in those states.

This summer, we reported that many states with federally facilitated marketplaces had imposed requirements more stringent than the federal rules governing the navigator program. Supporters of these efforts say that more regulations are necessary to ensure that navigators are well trained and protective of consumers’ rights. However, some of the new restrictions seem likely to prevent navigators and other consumer assisters from doing the jobs they were created to do.

17 states hinder consumers from getting help in health insurance marketplaces

On the Road Again: The Dangers of Transporting Ailing Inmates

Source: Christina Mason, Tod W. Burke and Stephen S. Owen, Corrections Today, Vol. 75 no. 5, November/December 2013
(subscription required)

Every day, in communities throughout America, correctional officers, sheriff’s deputies and federal marshals must transport inmates from secure facilities to medical clinics and hospitals for treatment. Every transport is a risky venture for corrections officials, medical staff, and the public, because the possibility that the inmate may seize an opportunity to escape is ever-present. This article will examine the problems posed and the risks inherent anytime an inmate is removed from the security of a correctional institution and taken to a medical facility where proper security is difficult to maintain.

The Paitent Protection and Affordable Care Act: What Are the Facts, and Where Do We Go From Here?

Source: Viola Riggin, Corrections Today, Vol. 75 no. 5, November/December 2013
(subscription required)

…This raises several important questions: How does this act really affect the incarcerated population? How do we define “inmate” and “inmate patient” within the health insurance arena, and what rights and requirements do inmates have to access and comply with PPACA? Are they covered under the “Patient’s Bill of Rights?” The American Correctional Association’s Coalition on Correctional Health Authorities (CCHA) formed a working group to evaluate the data, understand the language of this extensive law and the provide an unbiased look into how the new mandate may affect the incarcerated population. The CCHA-PPACA working group has spent many hours assisting secretaries and directors of corrections in understanding and developing a plan for managing this new act. The following provides an outline of that work….