This post summarizes a series of blog posts highlighted on the WisKids blog, in anticipation of the Supreme Court ruling on health care reform.
#1 – Maintenance of Effort (MOE)
The MOE requirements in the Affordable Care Act (ACA) are intended to preserve Medicaid and CHIP coverage during implementation of the law, and as the economy is still recovering. They are doing just that in WI, where the requirements preserved BadgerCare for over 29,000 children this year.
#2 – Coverage for Young Adults
Because of the ACA, the number of adults under age 26 who are on their parent’s health insurance plan has increased by about 6.6 million between November 2010 and November 2011, according to the Commonwealth Fund. That includes 43,000 WI young adults, by recent HHS estimates.
In 2011, 1.1 million WI families had access to preventive care thanks to the ACA. This allows for early detection of health problems, to optimize outcomes before they become expensive conditions.
#4 – Preexisting Condition Protections for Children
An estimated 94,700 children in WI with preexisting conditions like asthma or diabetes now cannot be denied care or coverage simply because they already have known health care needs.
#5 – Increased Accountability and Transparency on Insurance Costs
Insurance companies are now required to spend at least 80% of premium dollars on health care, and justify any significant rate increases. These features help ensure that WI families have access to affordable coverage.
The ACA is helping to close the donut hole, providing free preventive care in Medicare, and strengthening Medicare by investing in reforms for people who are “dual-eligible” and cracking down on waste, fraud and abuse. About 74,000 Medicare beneficiaries in WI reached the donut hole in 2009, and 232,685 seniors in WI on Medicare got at least one free preventive care service in the first five months of 2012.
#7 – Provider Payment Reforms and Care Coordination
The ACA has given a big boost to efforts to fundamentally change the health care business model to reward quality and efficiency, including, Accountable Care Organizations, Co-Ops, reducing hospital admissions and hospital acquired infections, and bundling payments.
Before the ACA, Wisconsinites could find themselves without care when they needed it most. Ending rescissions of coverage, removing lifetime limits, and phasing out annual limits on coverage are already making a difference by protecting our care and coverage.
#9 – Doctor Choice and ER Access
The ACA allows families to choose their primary care provider, and ensures that when you’re in need of ER care but away from home, you don’t get charged more for being out-of-network.
#10 – Community Health Centers, Primary Care Provider Support, and Small Business Tax Credits
This last post includes several miscellaneous parts of the ACA that have already begun helping improve health care access for WI families.
