10 questions and answers about the Open Enrollment 2018 period for the Affordable Care Act that ends on December 15.
Q: Has the Affordable Care Act (ACA) been repealed?
A: No. The ACA remains the law of the land. As in previous years, financial help to lower the cost of health coverage and care for those purchasing an ACA marketplace plan is available for those who qualify.
By David Thomsen, Policy Analyst, Health Policy Project, UnidosUS
The latest threat to repeal the Affordable Care Act (ACA) and gut the Medicaid program has been halted—for now. While this was certainly a positive development for our community, we must quickly pivot to critical work in other areas. One of our biggest concerns is that currently, the Children’s Health Insurance Program (CHIP) is at risk of ending and leaving nearly nine million children across the country without the affordable care they need to grow up healthy.
Last week, while Congress was focused on undermining the ACA, they missed the September 30 deadline to reauthorize funding for a program that last year insured nearly nine million children, including many Latino children. UnidosUS has called on Congress to reauthorize CHIP funding, without further delay, through written testimony to the Senate Finance Committee, which is responsible for this program.
A bipartisan group of governors have sent a letter to Majority Leader Mitch McConnell (R-Ky.) urging him not to bring the Cassidy-Graham health care bill to the Senate floor. Read the full letter below.
By now you’ve no doubt heard about the many reasons to sign up for health insurance during the Affordable Care Act’s (ACA) open enrollment period, which ends January 31. Access to health care services such as a primary care doctor, free preventive services, and peace of mind for you and your family if someone gets sick are all compelling reasons. But there’s another important, practical reason to get covered: those who are not covered by January 31 may have to pay a fine at tax time.
In 2016, the tax penalty for not having health insurance will increase to $695 per individual ($347.50 per child) or 2.5 percent of household income. The amount of the penalty depends on which number is greater. According to an analysis by the Kaiser Family Foundation, among individuals who were uninsured in early 2015 and eligible to enroll in a marketplace plan, the average penalty in 2016 is $969.
There is good news, though. Financial help is available for those who have yet to purchase an ACA marketplace plan. According to the U.S. Department of Health and Human Services (HHS), eight out of 10 people eligible for marketplace coverage are also eligible for financial help.
In 2016, HHS estimates that seven in 10 returning marketplace customers will pay a monthly premium of $75 or less.
In many cases, having health insurance is more affordable than not having insurance and paying the penalty.
In this last week of open enrollment, many uninsured Latino families face a choice: either pay a tax penalty and lack access to critical health care services, or head to the marketplace and shop for a plan that fits their health needs and their budget.
Protect yourself from an unwelcome gift at tax time or debilitating medical bills that could threaten your financial security.
January 31 is the last day to sign up for health coverage at healthcare.gov or cuidadodesalud.gov. If you have questions, bilingual help is available for free by phone or in person. To see what local assistance is available in your area, call (800) 318-2596 or head to localhelp.healthcare.gov. This week make sure to look at your options, choose a health plan that fits your budget, and avoid the penalty!
Last week, President Obama vetoed a bill that would have left millions of Americans without health insurance and access to affordable, quality care. Since the law’s implementation, nearly 18 million people—including four million Latinos—have gained health coverage. Despite those important gains, efforts have continued by Republicans in Congress to dismantle the Affordable Care Act (ACA), culminating most recently in the passage of a bill repealing the ACA. Thanks to the President’s veto, the ACA continues to be the law of the land. Rather than focusing on stripping health insurance away from millions of people, Congress should work to build off existing gains and increase the opportunity for even more individuals and families to enjoy the peace of mind and financial security that comes with having insurance.
Despite the historic gains in insurance coverage, Latinos still have the highest uninsured rate in the nation, with one in five lacking health coverage. That is nearly three times the rate of non-Hispanic Whites. Our community stands to gain a great deal under the ACA as organizations like NCLR and our community partners in the NCLR Affiliate Network work to connect Latinos with the information and resources to enroll in health coverage that best meets their needs. At NCLR, we know there is more work to be done to ensure that everyone has access to quality, affordable health coverage. Now is the time to double down on these efforts, not reverse them.
As we look to the work ahead, Medicaid expansion—a critical opportunity to further increase the number of insured individuals—remains a key piece of unfinished business under the ACA. While 30 governors have accepted federal funds through the ACA, which allow more low-income people in their states to be eligible for Medicaid, the rest of our nation’s governors have not. These state decisions leave some of our most vulnerable without any opportunity for health coverage, putting them at greater risk of illness and medical debt. If states such as Texas and Florida—which have large Latino populations—expanded Medicaid eligibility, they could make a big difference in reducing the number of uninsured. In fact, if every state expanded Medicaid, nearly 3.7 million Latinos could gain health insurance. We need leaders to step up and do what’s right on behalf of their most vulnerable residents.
Health care is an important issue to many Americans, including Latinos. A recent Gallup poll found that the majority of Americans believe that government should be responsible for ensuring that everyone has health coverage. When Gallup compared the views of Whites and Non-Whites, 65 percent of Non-Whites agreed that the government should be responsible for ensuring health coverage, compared with 44 percent of Whites. The Latino community has experienced historic gains in coverage thanks to the ACA, and we need leaders with the vision and commitment to advance these gains for the well-being and future success of our families and our country.
The NCLR Affiliate educates our community on obtaining and using health insurance
What is the main concern Hispanic Unity of Florida hears from your community members regarding the Affordable Care Act?
Hispanic Unity counselors and navigators have heard a variety of concerns regarding the Affordable Care Act. Most of the time, the concern is about the tax penalty for not having health insurance. Consumers know that if they do not enroll for coverage they may have to pay a fee when they file their taxes. The per-person charge in 2016 will jump to $695 per adult and $347.50 per child, topping out at $2,085 per family. The income-based penalty rises to 2.5 percent of the annual income.
Another concern we have heard in the community regarding the Affordable Care Act is the lack of knowledge of the health insurance system. Most people have difficulty understanding complex terms like deductible, coinsurance, or tax credits. It is fairly understandable because this program is new for almost everybody. But, thanks to our trained navigators and certified application counselors, we can help clarify these terms to make them more understandable to our clients.
Lastly, a concern particularly true in Florida is the lack of eligibility due to low income. We hear from consumers who earn less than 100 percent of the federal poverty level that they do not understand how it is that they do not qualify for tax credits if their income is low.
How do navigators and others in your organization talk to people in your community about the value of health insurance, even for those who consider themselves healthy?
We emphasize that there are many options available no matter what their health situation is. There are plans for the healthier population while there are also plans for those who use health care services more often.
The best thing about this program is that it is not allowed to refuse coverage to anyone based on pre-existing conditions. Sick or not, these plans can work for anybody.
We also like to remind them that these plans can help people save money on out-of-pocket costs in case of a dire emergency. Our navigators inform consumers about the importance of health insurance by explaining different scenarios that could happen unexpectedly, such as getting sick or getting into an accident. We also explain the difference in costs between having insurance and not having insurance when going to the emergency room. It is important to make them understand that prevention is key. The same way they cover their cars and their homes in case of an accident and or a natural disaster, they must make their health coverage a priority. We help them understand that staying healthy to enjoy their other assets makes more sense.
Is cost a concern? Do people understand that they most likely qualify for financial assistance to enroll in a health plan? How do you help them with this concern?
Yes, premium cost is a top concern for health insurance shoppers. We help consumers understand that financial assistance is available for those who qualify. We make sure they understand that the amount of financial assistance they receive depends on income, household size, and many other factors. When we help consumers apply for coverage in the Health Insurance Marketplace, we help them find out whether they qualify for a “premium tax credit” that lowers the premium, which is the monthly amount they will have to pay to their insurance carrier.
However, we know that not everybody will qualify and some might fall into what is called the “coverage gap.” This is one of the most disconcerting barriers some of our clients ultimately face.
Are you still seeing most people come in to get covered for the first time, or are more coming in for help to re-enroll?
There is a mix of those who want to enroll for the first time and people who want to renew their current plan. There are also others who had one plan but want to switch to another plan for a variety of reasons. Also, there are people who enroll for the first time because they had a situation change such as increased income or a change in their family configuration. Most people do come to re-enroll in the program. We would say it is about 60 percent of people are re-enrolling, while 40 percent are enrolling for the first time.
Does Hispanic Unity of Florida offer assistance to people on how to utilize their ACA insurance once they have it?
Hispanic Unity of Florida understands people may be overwhelmed by their choices in the Marketplace. After our counselors have helped clients choose a plan that meets their specific family needs, we also help understand how to use their coverage to get the care they need. Hispanic Unity of Florida offers all sorts of assistance regarding health plans. We have knowledge of how to use the insurance plans, how to look for doctors and prescription drugs that are covered in their plan, and other inquiries about their designated health insurance company.
After their application, we help consumers understand key terms, such as copayments, deductibles, and out-of-pocket limits. Consumers always leave better informed about the Marketplace and the insurance company they applied with. If consumers have any concerns or questions regarding their health coverage, they know that they can come back to see an assister to help them get the coverage that is right for them and help them move from coverage to care.
Florida still has one of the highest rates of uninsured children in the United States. Are you seeing more community members coming in to get their children covered? Do parents understand that even if they do not qualify, they can still enroll their citizen children in coverage?
We always explain the importance of having all the family covered. No one should be left behind. We make sure our participants understand that even when they are not qualified for coverage, we can submit the application and let the Marketplace send the information to Florida KidCare (CHIP) or Medicaid to confirm their eligibility and help them.
We also explain that when it comes to enrolling children in health plans, once an application is submitted, the Health Insurance Marketplace will send their information to a designated health company (Medicaid or CHIP) so they can make a final determination. We also explain to our clients that children who do not qualify for either Medicaid or CHIP can enroll in a plan with their parents until the age of 26.
Four million Latinos have purchased health insurance through the Affordable Care Act (ACA) since the law’s implementation. Join them by signing up for health coverage so you, too, can get quality affordable health coverage.
This Sunday, November 1 is the start of the third ACA open enrollment period. Sign up for coverage by January 31, 2016 by calling 1-800-318-2596 or visiting www.healthcare.gov or www.cuidadodesalud.gov. Whether you are renewing coverage or getting health insurance for the first time, take the time now to learn about your options and the financial help that may be available.
Here’s how you can get ready to get covered:
Understand your options and choose the health plan that best meets your needs. Check out the benefits and costs of available plans at healthcare.gov or www.cuidadodesalud.gov. You can also find out if you and your children are eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
Gather key documents and information before you apply. Several documents—such as a permanent resident card (or green card), a reentry permit or an employment authorization card—can be used to prove immigration status on the health application.
Determine who in your household is applying for coverage. Have information ready for each person, including everyone’s home and mailing addresses. Make a general estimate of your income for the coming year to get an idea of the savings for which you might qualify.
Get one-on-one help. Free local, in-person assistance is available to answer your questions and help you enroll in a health plan. To find out where you can get assistance in your area, call 1-800-318-2596 or visit healthcare.gov.
If you do not have an eligible immigration status and do not qualify for coverage, you can apply on behalf of your eligible dependents. An ineligible parent, for example, can apply on behalf of an eligible child.
Enroll in a health plan by January 31, 2016. Share this information with your family and friends and encourage them to get covered, too! Be prepared and understand your options so you can find the best health care plan for you and your loved ones.
Starting in May 2016, children in California who meet income eligibility requirements but who are otherwise ineligible due to immigration status will be eligible for public coverage via the state’s Medicaid program, Medi-Cal. The Golden State is the largest one to join New York, Washington, Illinois, Massachusetts, and the District of Columbia to cover all children. Governor Jerry Brown signed SB 4 into law recently, paving the way for the expansion of health coverage to all eligible children under the age of 18, regardless of immigration status. The bill originally intended to broaden eligibility to include adults as well, but was narrowed during negotiations in June.
State Sen. Ricardo Lara, who led the effort said, “It’s a precursor for us to getting healthcare for all in the next year or so.”
In the meantime, 170,000 children will be eligible for coverage when the law goes into effect next year. NCLR remains committed to increasing the number of individuals with quality, affordable, and accessible health coverage and care, regardless of who they are, where they live, or how much they or their families make.
California’s effort is a significant step toward a more inclusive health care environment for all.
In the past few years, millions of eligible children have gained access to free or low-cost health care through Medicaid and the Children’s Health Insurance Program. Unfortunately, more than three million eligible children are still not enrolled, including many Latino children.
NCLR is delighted to join Salud Today and The Centers for Medicare and Medicaid Services’ Connecting Kids to Coverage National Campaign in hosting a live Twitter chat on Tuesday, September 15. From 1:00 to 2 p.m. EDT, users can tweet questions, ideas, and their own experiences surrounding this crisis facing our children.
We’ll discuss the importance of health coverage for children, the crucial information families need in order to receive insurance and care, health care issues impacting Latino families in the United States, and how you can help spread the word to families with eligible children.
Join us on Tuesday, September 15 to learn how you can help close the health care gap and make sure all eligible children—and parents, too—get the coverage and care they need. Be sure to use the hashtag #SaludTues to follow the conversation on Twitter and share your stories, ideas, and resources that can help connect our children with the care they so desperately need.
Five years ago today, the country experienced a pivotal moment when the Affordable Care Act (ACA) was signed into law. Since passage and subsequent implementation, millions of Americans have started to enjoy its benefits, including Latinos. While the increase in Americans with quality, affordable health coverage should be celebrated, it’s important to highlight the other ways the law is benefiting millions of Americans. To mark the ACA’s fifth birthday, here are five ways the law is benefiting the Latino community.
1. Investing in prevention
8.8 million: The number of Latinos with private insurance who now have access to expanded preventive services with no cost-sharing, including mammograms for women, well-child visits, and flu shots for all children and adults.
9 million: How many Latina women with private health insurance now have guaranteed access to women’s preventive services without cost-sharing, including breastfeeding support and counseling, screenings for cervical cancer, and prenatal care.
2. Enhancing quality
10: The number of essential health benefit categories private marketplace plans must cover, including recommended preventive services, prescription drugs, and mental health and substance use disorder services.
3. Creating new coverage opportunities for young adults
913,000: Latino adults ages 19–26 who would have been uninsured, including 375,000 women, but now have coverage either on their own plan or a parent’s employer-sponsored plan.
4. Improving consumer protections
11.8 million: The number of Hispanics, including 4.4 million Latinas, who no longer have lifetime or annual limits on their health insurance coverage. And Section 1557, a civil rights provision of the law, prohibits discrimination on the basis of race, class, gender, sexual orientation, and other statuses.
5. There’s room to grow to ensure all who are eligible are able to experience the full benefit of the law
1 million: The number of low-income Latinos who stand to gain coverage if states like Florida and Texas expand Medicaid eligibility.
There are many other ways the Affordable Care Act is benefiting Latinos and as implementation continues, we’ll see even more Americans benefitting. Of course, this is notwithstanding congressional attempts to repeal the law. It will take all of us to ensure Republican efforts to undermine the law are not realized. We know what’s at stake for millions of Americans, including Latinos, and NCLR will continue working to protect and advance the gains that have been made to ensure the potential of the law is fulfilled.