This is the tenth and final in a series of blog posts celebrating the benefits that the Affordable Care Act (ACA) provides to people with disabilities. For the full list of prior blog posts, see last Friday’s news item.
The Future of the ACA – Where Do We Go from Here?
Over the last ten days, we’ve celebrated what the ACA means for people with disabilities and the advancements that have occurred for expanding coverage for those in the disability community. However, we recognize that the ACA was not a perfect solution and issues still exist with people getting access to the health care they need. As we stated in Thursday’s blog on mental health parity, there are still some issues that exist in the current system and many which extend beyond just mental health. Some of these issues include:
- Limited provider networks/lack of network adequacy
- Limited formularies/discriminatory pharmacy design
- Lack of plan transparency
- High out-of-pocket costs
- Confusion on the definition of “rehabilitation” and “habilitation” services and supports
- Confusion on the coverage of prosthetic devices and durable medical equipment
- Delays in getting plan information once consumers are enrolled
- Discrimination by health care providers against persons with visible disabilities, mental illness, and particularly substance use disorder
- Confusion, uncertainty, and lack of transparency in health plan “medical necessity” determinations
- Confusion and uncertainty in coverage policy and service delivery for persons who have Medicaid and other forms of insurance coverage, including Medicare
When discussing ways to reform healthcare with elected officials and other policymakers, AAHD stands for proposals which would address the issues above while also protecting the advancements that were made by the ACA as we have outlined over the last several days. After the 2016 presidential election, we recognized that changes to health care reform were going to be attempted. Therefore, we wrote our statement on the ACA entitled “Preserve the Protections Provided by the Affordable Care Act.” This outlined the fundamental protections that we believed the ACA provided which needed to be part of any future health care reform law.
We do have concerns over several developments that have happened over the last several years as it relates to the ACA and Medicaid. These include:
- Current litigation pending at the US Supreme Court attempting to overturn the ACA
- Regulatory changes which make it easier for insurance companies to offer “short-term” health plans which do not abide by the same consumer protections provided by the ACA and which lure healthier consumers away from ACA plans thereby driving up the costs of ACA plans for those that need the more comprehensive benefits packages offered by ACA plans
- Approval of work requirements for states within the Medicaid program
- Guidance by CMS encouraging states to submit plans which would transition their Medicaid program to a block grant
We have advocated for improving on the ACA and strengthening the Medicaid program in ways that help people with disabilities preserve their access to coverage, continue to have flexibility of choices and maintain their right to live independently and in the most integrated setting. As such, we support proposals that best accomplish these goals.