The Patient Protection and Affordable Care Act, often referred to simply as the ACA or Obamacare, was signed into law on March 23, 2010. The ACA is intended to expand access to health insurance coverage for millions of uninsured Americans by expanding eligibility for Medicaid and developing health insurance marketplaces where uninsured persons may be eligible for subsidies to make private health plans more affordable. While expanding access to health insurance is a big part of the ACA, there are many other purposes of the law, including provisions intended to reform the health care delivery system to produce better patient outcomes at lower cost.
AOTA was very active in the legislative process leading up to the passage and signing of the ACA, working to achieve victories such as inclusion of rehabilitation and habilitation in the essential health benefits package. AOTA has also been monitorting the regulatory process at the federal and state levels as the ACA has been implemented, and has been advocating for occupational therapy practitioners and consumers. The dynamic environment created by health care reform creates opportunities, but vigilant monitoring of implementation activities and carefully executed advocacy efforts are necessary to ensure occupational therapy is valued and protected in the future.
Please also see the Health Care Reform Implementation page on AOTA's website at: http://www.aota.org/Advocacy-Policy/Health-Care-Reform.aspx
The Portland Press Herald: Maine becomes first state to approve Medicaid expansion by popular vote
Thirty-two states and Washington, DC have expanded Medicaid under the ACA. On Tuesday, Maine became the first state to do it at the ballot box, with 59 percent of voters supporting expansion. Other states have expanded through an act of the state legislature or the governor’s executive authority.
Bangor Daily News: As Mainers endorse expanding MaineCare, feds back LePage methods to shrink it
As Mainers were going to the polls on Tuesday, the Administrator of the Centers for Medicare and Medicaid Services (CMS) was telling state Medicaid directors about her agency’s plans to “refit” the state-federal program. She promised to work closely with states that want to use the waiver process to impose new conditions on Medicaid enrollees. Maine currently has such a waiver awaiting CMS approval.
Washington Post: States will be allowed to impose Medicaid work requirements, top federal official says
Administrator Seema Verma’s speech to the National Association of Medicaid Directors (NAMD) forcefully endorsed work requirements (or “community engagement requirements”) for Medicaid members and condemned the Medicaid expansion for covering “able-bodied” adults. The speech pleased officials from the half-dozen states trying to implement work/community engagement requirements.
Washington Examiner: Trump readies executive order to unravel Obamacare’s individual mandate, GOP senator says
An executive order to scuttle the ACA’s individual mandate may be coming soon, according to one GOP senator. The executive order, which could broaden hardship exemptions and stop the collection of fines, was put on hold while Congress debates whether to repeal the individual mandate in the tax bill.
Kaiser Family Foundation: How Many of the Uninsured can Purchase a Marketplace Plan for Less Than Their Shared Responsibility Payment?
Open enrollment for the ACA’s health insurance marketplaces runs through December 15th in most states. The tax penalty for not having insurance is still in play. According to this issue brief from the Kaiser Family Foundation, 70% of people who are eligible for subsidies but still uninsured (5.8 million people) could get a bronze plan in 2018 for less than they would pay in individual mandate penalties for staying uninsured.