By Tribuna Staff
The Affordable Care Act has already covered one in four uninsured Americans – more than ten million – and improved coverage for virtually everyone with health care coverage. Insurers can no longer discriminate against preexisting conditions, charge women more just for being women or put caps on the care you receive. Hospitals, doctors and other providers are changing the way they operate to deliver better care at lower cost. But if you are wondering what has been its impact in our state, below is how the Affordable Care Act has affected families in Connecticut.
After Health Reform: Improved Access to Care
- Gallup recently estimated that the uninsured rate in Connecticut in 2014 was 6 percent, down from 12.3 percent in 2013.
- Prohibits coverage denials and reduced benefits, protecting as many as 1,554,628 Connecticut residents who have some type of pre-existing health condition, including 191,534 children.
- Eliminates lifetime and annual limits on insurance coverage and establishes annual limits on out-of-pocket spending on essential health benefits, benefiting 1,386,000 people in Connecticut, including 525,000 women and 367,000 children.
- Expands Medicaid to all non-eligible adults with incomes under 133% of the federal poverty level. There were over 736,000 people enrolled in Medicaid and CHIP in Connecticut in March 2015.
- Establishes a system of state and federal health insurance exchanges, or marketplaces, to make it easier for individuals and small-business employees to purchase health plans at affordable prices, through which 98,269 people in Connecticut were covered in March 2015.
- Has created a temporary high-risk pool program to cover uninsured people with pre-existing conditions prior to 2014 reforms, which helped more than 676 people in Connecticut.
- Creates health plan disclosure requirements and simple, standardized summaries so 2,165,700 people in Connecticut can better understand coverage information and compare benefits.
After Health Reform: More Affordable Care
- Creates a tax credit to help 77,114 people in Connecticut who otherwise cannot afford it purchase health coverage through health insurance marketplaces.
- Requires health insurers to provide consumers with rebates if the amount they spend on health benefits and quality of care, as opposed to advertising and marketing, is too low. Last year, 69,186 consumers in Connecticut received $3,019,862 in rebates.
- Eliminates out-of-pocket costs for preventive services like immunizations, certain cancer screenings, contraception, reproductive counseling, obesity screening and behavioral assessments for children. This coverage is guaranteed for more than 1,819,938 people in Connecticut, including 746,444 women.
- Eliminates out-of-pocket costs for 467,148 Medicare beneficiaries in Connecticut for preventive services like cancer screenings, bone-mass measurements, annual physicals and smoking cessation.
- Phases out the “donut hole” coverage gap for 60,610 Medicare prescription drug beneficiaries in Connecticut, who have saved an average of $1,067 per beneficiary.
- Creates Accountable Care Organizations consisting of doctors and other health-care providers who share in savings from keeping patients well while improving quality, helping 165,409 Medicare beneficiaries in Connecticut.
- Phases out overpayments through the Medicare Advantage system, while requiring Medicare Advantage plans to spend at least 85 percent of Medicare revenue on patient care. Medicare Advantage enrollment has grown by 66,932 to 159,067 in Connecticut since 2009.
Access Health CT (also known as the Connecticut Health Insurance Exchange) was created by the Connecticut Legislature in 2011, established to satisfy the requirements of the federal Patient Protection and Affordable Care Act.
The 2015 Access Health CT Open Enrollment period for individual health and dental insurance is now closed. The next Open Enrollment period, for 2016 coverage, begins on November 1, 2015 and ends on January 31, 2016. Enrollment in Medicaid (HUSKY) and the Children’s Health Insurance Plan (CHIP) is open year round for eligible persons and families.
You may also still be eligible to enroll in coverage throughout the year if you or a member of your household has experienced a Special Enrollment Qualifying Life Event in the past 60 days or you will in the next 60 days. Qualifying Life Events may include: childbirth, adoption and death of a member of the household, marriage, loss of current health care coverage, loss or reduction in employer insurance contributions, new legal Connecticut or U.S. residency or lawful U.S. presence.
For more information, call 855-805-4325 or visit www.accesshealthct.com to see if you may qualify.