Tag Archives: health reform

Understand role of catastrophic health plans and who’s eligible

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

ambulanceSo did the Obama administration let potentially millions of Americans buy the same kind of “junk” insurance policies that were being canceled because they didn’t meet new requirements of the health law? Not exactly.

In late December the White House said that anyone who had their plan canceled could, if they wished, get a “hardship exemption” from the individual mandate and purchase a catastrophic health plan (if such plans are available in their region).

These plans are far from generous. They aren’t designed to be. But they do have certain basic consumer protections that may meet the needs of some families. A big surge of individuals or families taking up this option could, however, hurt the overall exchanges if lots of healthy people take them. People covered under these plans could “count” toward the goal of getting 7 million Americans covered by the end of March 2014. But they don’t count as part of the exchange risk pools. They are apart. And the insurers fear that they will siphon off some of the healthier people that they need in the pool to keep costs sustainable. Continue reading

HealthCare.gov issues affect Medicaid enrollment

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Here’s another HealthCare.gov problem – and a workaround – that haven’t gotten much attention.

People can apply for Medicaid (traditional or expanded) via the federal HealthCare.gov website. But the applications still have to get transferred to the states which have to process them to finalize enrollment in the actual state program. And it’s supposed to be done by Jan. 1.

Guess what? That was a problem. With all the website woes, the feds weren’t able to process that  information and had pushed back deadlines. Then, quietly, on the Friday of Thanksgiving weekend, CMS offered a transitional “administrative” fix through this federal policy guidance.

The states are allowed to use the minimal information on the so-called “flat files” to finalize the Medicaid status. The flat files had been pretty bare bones but CMS says expanded files will “include data elements such as: date of birth, Social Security number, eligibility category used for assessment or determination, and verification inconsistencies. The file will identify individuals who have been assessed or determined eligible for Medicaid and CHIP on the basis of modified adjusted gross income (MAGI).”

It would be good to check in with your state’s Medicaid director. Is this enough? Too little, too late? Will people be correctly enrolled in Medicaid by Jan. 1 – or will some be left uncovered, even if they did their part of the application process correctly?

Here’s a list of state Medicaid directors from the National Association of Medicaid Directors.

Covering health reform’s cancellation crisis

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Image by Enokson via flickr.

Image by Enokson via flickr.

A few weeks into the cancellation crisis – some of which could be mitigated by the delay President Obama just announced – here’s what we know and what we don’t. In an upcoming post, I’ll highlight two very good stories exploring aspects of this.

Who’s affected?

The estimates on how many people are affected by plan cancellations vary widely. We’ve seen anything from “hundreds of thousands,” which is too low, to “up to 14 million,” which is too high. Continue reading

HHS releases enrollment numbers for marketplaces

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

The U.S. Department of Health and Human Services has released the much-anticipated numbers for the first month of enrollment in the ACA’s insurance marketplaces.

A quick breakdown from the press release:

  • 975,407 customers have gone through the process but have not yet selected a plan
  • 106,185 Americans selected health plans
  • 396,261 assessed or determined eligible for Medicaid or CHIP

The 28-page issue brief (PDF) from HHS has plenty of other numbers, including those for individual states and draws comparisons between the healthcare.gov rollout and the launch of other programs, including the Federal Employees Health Benefits Program, Medicare Part D, Massachusetts’ Commonwealth Care, and the Children’s Health Insurance Program.

Shared wisdom: Finding sources while avoiding politics

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Jason Hidalgo

Jason Hidalgo

It’s advice we see repeated over and over: Get the faces and stories of real people into your articles about health reform.

That’s easier said than done, given the intense opinions and politics surrounding the Affordable Care Act and some reporters have found that using social media to reach out and find sources only results in angry responses from people who want to share their opinions – but not necessarily their experiences with health care and insurance.

Jason Hidalgo, a business reporter at the Reno (Nev.) Gazette-Journal, wrote a series of articles showing how a variety of people are affected by a lack of insurance. In the Shared Wisdom section of AHCJ’s health reform core topic area, he explains how he was able to use social media to find sources without engaging in the political discourse.

See his advice to fellow reporters on finding sources.

Health reform D-Day? Or not for a few more months?

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

At the AHCJ event we had in Washington, D.C., a few weeks ago, I talked about why there’s nothing magical about Oct. 1 – and why it’s also such a pivotal day.

From a strictly policy viewpoint, today is just the start of a six-month open enrollment period that ends March 31. We won’t really know for some time how many people the exchanges are enrolling or what the emerging risk pool looks like (men versus women, older versus younger, sicker versus healthier). We will probably hear about people having problems getting on the exchange websites or call centers – we won’t necessarily hear as much about people who don’t encounter problems. We’ll find out about glitches – computer problems, call center snags. Some may be serious – but if they are fixed relatively quickly, they aren’t fatal. The Medicare drug benefit had all sorts of snags when it opened, but within a few weeks it was working quite well.

But that’s the staid policy viewpoint and all of us know that – as the government shuts down, as the “Obamacare wars” are well into year 4 – this is not just a policy story. Even the wonkiest, most policy-minded reporters among us know this is a political story, a political dynamic, too. So we aren’t going to be deluged with press releases that say “Health insurance exchanges open – let’s give it six months to make a judgment.” We’re going to be hit with a tidal wave of advocates and enemies trying to seize the message and declare victory or defeat. It will be a battle of the “I told you sos.”

And since the enrollment period – with all its problems and challenges – will go on for three months until the actual health coverage begins on Jan. 1, that’s three more months to focus on problems without being able to point to benefits. That lag will be politically challenging for supporters of the law.

It won’t just be politicians and advocates making snap judgments – some of us may also face pressure from editors to come up with a grand and definitive and immediate answer – it’s working, or it flopped. By, like, noon.

Try hard to keep your eye not just on what happens in the coming hours – but the far more important question of what’s going to happen in the coming weeks, months and years.