Hi All,
As members of your APNA staff, Meaghan Trimyer and I were honored to represent the Association at the White House Affordable Care Act Briefing for the Mental Health Community on Wednesday, August 21st. Below is the report that we submitted to the Board of Directors. Please feel free to comment or message me with any questions.
Thanks,
Lisa Nguyen
APNA Manager of Professional Development
The White House Affordable Care Act Briefing for the Mental Health Community
Wednesday, August 21, 2013 | 1:00pm – 3:00pm
The Eisenhower Executive Office Building, South Court Auditorium
APNA Representatives:
Lisa Nguyen, MS, Manager of Professional Development
Meaghan Trimyer, Communications Coordinator
Introduction
Sarah Bianchi, Director of Economic and Domestic Policy for the Vice President, provided an introduction to the briefing. She covered the main points of the Administration’s current efforts, including the National Dialogue on Mental Health, the $130 million initiative to address workforce issues in the psychiatric mental health arena (the only portion of the Gun Control bill which passed), and the expansion of insurance coverage through the Affordable Care Act.
Panel
Moderator:
Howard K. Koh MD, MPH, Assistant Secretary for Health, U.S. Department of Health and Human Services
Panel Members:
-- Kristin Link-Young, Director of Coverage Policy at HHS
-- Pam Hyde, Administrator of Substance Abuse and Mental Health Services Administration
-- Stephanie Valencia, Special Assistant to the President and Principal Deputy Director of the Office of Public Engagement
Kristin Link-Young provided an overview of the Health Insurance Marketplace:
-- A “single website, like Expedia or Kayak, but for health insurance” – http://marketplace.cms.gov
-- Kristin made sure to point out that the site includes only qualified health insurance plans, indicating that certain standards must be upheld for those plans to be a part of the marketplace
-- Open Enrollment: 10/1/13 – 3/31/14
-- Enrollment will be through a single streamlined application.
-- It should take about 8 minutes for a single person to fill out and about 20-30 for a family.
-- Applicants can choose from four levels of coverage.
-- Applicants can choose amongst a variety of Qualified Health Plans, issued by private health insurance companies. These plans will cover all 10 categories of “essential health benefits,” including mental health and substance use.
-- In 2014, anyone who does not have minimum essential coverage and who has access to an affordable health insurance policy will have to pay a fee.
-- There is some financial assistance available through the marketplace – Kristin mentioned the advance premium tax credit (paid directly from the marketplace to the insurance company) and a reduced cost sharing option.
-- Expanded Medicaid Program:
-- Available to anyone with income under 133% of the federal poverty level
-- It is expected that all states will join the expanded Medicaid program eventually, due to incentives.
-- It will be coordinated with the Health Insurance Marketplace.
-- A variety of support will be available for persons enrolling: online chat, call centers (in almost any language), navigator programs, insurance agents and brokers
Pam Hyde, Administrator of SAMHSA, focused more specifically on the ACA and mental health and substance use care:
-- Cost and lack of insurance are the biggest reasons the people with mental health and substance use disorders do not seek treatment
-- The ACA will expand coverage to approximately 62 million Americans, an estimated 11 million of whom have mental health and substance use disorders.
-- The ACA is providing funding for innovative new programs and tools in mental health care delivery.
-- The ACA promotes care integration through health homes and interdisciplinary health teams.
-- The ACA National Prevention Strategy provides funding for preventative screenings for depression (adults and children) and substance use disorders (adults).
-- Parity:
-- About one third of those who currently have health insurance have no coverage for substance use treatment.
-- About 20% of those who currently have health insurance have no mental health care coverage.
-- The ACA will require this coverage by including substance use and mental health care as essential benefits
-- SAMHSA’s initiatives to get people enrolled include coalitions who are committed to promoting the marketplace and the dissemination of the HHS ACA materials.
-- Creation of virtual toolkits on training, communication tips, education
-- BH Business – SAMHSA program to increase provider readiness (http://bhbusiness.org/)
This sounded like something some APNA members might be able to get involved in… link to their application: http://bhbusiness.org/General_Application
Stephanie Valencia covered how organizations can help with outreach:
-- Educating the 80% of Americans who are already benefitting from the Affordable Care Act on how they are being affected.
-- The 2014 enrollment goal for the Health Insurance Marketplace is 7 million:
-- This needs to be composed of a balanced risk pool in order to keep health insurance affordable, so a large focus is on healthy 18-35 year olds who are not insured.
-- 1/3 of uninsured 18-35 year olds live in California, Texas, and Florida.
-- There is a need for neighborhood level, coordinated targeting and outreach.
-- Information to disseminate:
-- The insurance application has been reduced from 21 pages to 3 pages.
-- 90% of the currently uninsured will receive a break in costs.
-- Open enrollment begins 10/1 at marketplace.cms.gov:
-- For coverage to begin 1/1/14, you must apply by 12/15/13.
-- Once the program is kicked-off, the rule will be: if you apply before the 15th of the month, your coverage will start on the 1st of the next month.
-- Helpline: 1-800-318-2596
-- Medicaid Expansion:
-- Incarcerated persons can enroll in Medicaid at any time.
-- Encourage those in non-expansion states to apply anyway – it will be good to capture data on who is being turned down & hopefully pressure these states to participate in Medicaid expansion.
-- These folks will still be able to obtain discounted coverage through the MAGI (Modified Adjusted Gross Income) conversion in the marketplace
-- A clarification on Medicaid is due to be released by CMS soon
-- A $67 million navigator grant will ensure that every federally funded community health center has a navigator.
-- Resource for businesses: http://business.usa.gov/healthcare
-- Nondiscrimination Standards for Insurance Carriers: http://www.cms.gov/cciio/index.html
-- Stephanie mentioned that we could sign up to be a champion for coverage as an organization… will look into how we do this!
Additional points addressed in the Question & Answer Session:
-- Patrick Kennedy called for a consumer toolkit that would enable consumers to fight for mental health care coverage and an easy appeals process the consumers will readily utilize.
-- The Administration is putting money towards expanding mental health care access in schools.
-- There was a good amount of discussion about Medicaid and states that have elected not to expand… NAMI Northern VA asked about the 70% of people with schizophrenia & bipolar who aren’t able to work.
-- Pam Hyde addressed the issue that currently people have to say they are disabled in order to get coverage, but research shows us that a lot more could work with utilization of some of these mental health and substance use services that are going to be more accessible through the ACA.
Conclusion:
The overall take-home message was the government isn’t the best at communicating the benefits and educating the public about the ACA, so they need our organizations to help champion the cause. They have provided a wealth of resources to assist in this effort.
APNA seems on the right path (if not ahead of the curve) with our ACA Resources page, email to the membership, and press release.