Tag: health care

The Affordable Care Act: What It Means For You

The law represents the biggest change in American health care since the introduction of Medicare more than 50 years ago.

President Obama’s signature on the Patient Protection and Affordable Care Act, sometimes known as “Obamacare.” The law represents the biggest change in American health care since the introduction of Medicare more than 50 years ago. Image via MinnPost.

In 2010, the Patient Protection and Affordable Care Act became law. Sometimes called “Obamacare,” the law is big, complex, and the subject of far too much political punditry. Whether you approve of the law or not, its major provisions start to go into effect soon, and it’s important to understand what you might need to do. If you have any questions about how the new law will affect you, please feel free to contact my office at (617)-722-2380. You can also read the Commonwealth’s Affordable Care Act FAQs here.

Here in Massachusetts, we’ve had an individual health insurance mandate for a while now, and as a result, we already have the lowest percentage of uninsured people in the country. Because our law served as a model for the rest of the country, most of us will see absolutely no changes to our health insurance. With all the misinformation that’s circulating, I want to make it clear that the following groups of people will see no changes to their health insurance:

People who currently get health insurance through their employer. If you get health insurance from your employer—and 72.9% of us do—you should receive a notice like this one on or before October 1, 2013. You’re free to shop for a different plan if you’d like, but if you’re happy with your current plan, you can keep it.
• People under 26 years old who are currently on their parents’ insurance plans.
• People who are currently enrolled in Medicare or get their health insurance through the Veterans Administration.

If you’re in one of the three groups listed above, you don’t need to do anything, though you’re free to shop for health insurance options through the Commonwealth Connector. However, if you’re currently purchasing health insurance through the Commonwealth Connector, you will need to reapply and select which plan you’d prefer, even if you want to keep the plan you’re currently on. The Commonwealth Connector, along with Health Care for All and others, will be reaching out to affected citizens through phone calls, radio and TV ads, and even through door-to-door visits.

A large part of the new law deals with expanding access to health insurance, and the following groups of people may be able to afford (or afford to provide) coverage for the first time:

• A family of four earning less than $31,000 per year may qualify for low- or no-cost coverage through MassHealth. In fact, anyone earning up to 133% of the federal poverty limit (that’s $15,288 per year for individuals) now qualifies for MassHealth.
• Anyone earning up to 400% of the federal poverty limit is also eligible for “premium support” —subsidies from the government to help you purchase coverage from the Commonwealth Connector. That means that a family of four earning up to $94,200 per year qualifies for subsidies. If you’re an individual earning $45,960 or less each year, you qualify too.
• There are also tax credits for small businesses employing fewer than 25 full-time employees who make an average of $50,000 or less each. The Connector’s Wellness Track offers further rebates for small businesses who help their employees obtain health care.

There’s a lot more to the law than just what I’ve listed here, including the brand-new ability to shop for dental insurance through the Commonwealth Connector. If you have questions about how the law will affect you, please feel free to contact my office or the Health Care for All helpline at (800)-272-4232. You can also find easy-to-use resources here, and wonkier resources here.

The bottom line is this: starting on October 1, more people than ever will have the opportunity to obtain health insurance for less money than ever. And that’s something we can all be proud of.

A Public Meeting on “Dual-eligibles” and the Future of Health Care

A local group called Disability Advocates Advancing our Healthcare Rights (DAAHR) is holding a public meeting tomorrow from 1-3pm at The Paulist Center at 5 Park St. in Boston. Everyone with an interest in shaping health care delivery methods is encouraged to attend, but this meeting should be of particular interest to so-called “dual-eligibles.”

What’s a “dual-eligible?” In plain English, a dual-eligible is any person who qualifies for both Medicare and MassHealth. If this is a new term for you, that’s because it’s a fairly new term for all of us. Part of President Obama’s health care reforms called for a tighter and more efficient coordination between Medicare (which is administered by the federal government) and Medicaid (which is administered by the states). According to federal estimates, dual-eligible people make up 15% of Medicaid enrollment but account for nearly 40% of Medicaid costs. The Patient Protection and Affordable Care Act—better-known as Obamacare—awarded $1 million each to Massachusetts and 14 other states to implement pilot programs to deliver care in a seamless, cost-effective way for dual-eligible people.

On the national scale, this is Obamacare in action: a federally funded drive to let states create the health care models that will save us all money in the 21st century. On a local scale, this is a fantastic opportunity to make your voice heard and to help create a program that could become a model for the rest of the country.

If you are dual-eligible or know someone who is, I encourage you to attend tomorrow’s meeting. To request accommodations or for more information, please contact Allegra Stout (astout@bostoncil.org; 617-338-6665) or Florette Willis (willisflorette@yahoo.com; 617-297-2030).

Tim Celebrates Signing of Child Hearing Aid Law with Governor Patrick, Rep. Garballey, and Other Elected Officials

This afternoon, a group of concerned parents gathered with Representatives and Senators for Governor Patrick’s ceremonial signing of H.52, “An Act to Provide Access to Hearing Aids for Children.” I cannot tell you how many times I heard people at the ceremony saying, “This is such a good bill,” and that’s a testament to the hard work of my colleague Representative Sean Garballey, who was the chief sponsor of H.52.

Governor Patrick listens to parents describe the hardship of learning that their child was diagnosed with permanent hearing loss, and of the relief and hope that Rep. Garballey’s bill has brought to them and their children.

And it really is a good bill: H.52 plugs a critical gap in early-childhood health care by expanding on a 1998 law that mandates post-natal hearing screenings. While newborns have been screened for hearing loss for more than a decade, insurers were not required to cover the vital medical devices that would restore the gift of sound to these young lives.

I listened today as one mother after another talked about the sorrow they felt when they learned their children faced hearing loss, and the fear they felt when they learned that hearing aids were not covered by their health insurance. One mother, holding the hands of her 6-, 7-, and 8-year-olds, told us how her family faced a $15,000 decision every year, a decision that forced her and her husband to answer questions no parent ever wants to face. With the passage of this bill, that economic uncertainty—that sick, empty feeling in the pit of a parent’s stomach when an unexpected medical bill arrives—is a thing of the past for thousands of Massachusetts families.

As Governor Patrick pointed out, this hearing aid bill is part of a larger decision we all made as a Commonwealth, namely that “health care is a public good,” and one to which we all deserve access. With the passage of this bill, Massachusetts becomes the 20th state nationally to require insurers to cover the cost of hearing aids, and I’m proud to have co-sponsored this piece of legislation

Cambridge Health Alliance Modernizes for the Future

I spent part of this morning with the Cambridge Health Alliance (CHA), as they marked their transition to a medical home model of health care delivery.The medical home model is part-and-parcel of the health care bill we passed last session, emphasizing the need to identify and learn from accountable care organizations and mandating a transition to global payments away from the traditional fee-for-service model.

Tim speaks about his personal connection to the Cambridge Health Alliance and the importance of the progress that they continue to make as one of the Commonwealth’s safety net hospitals

The CHA is partnering with state and federal authorities as part of a $628 million program designed to increase the effectiveness of care delivery and to reduce operating costs. The program, known as the Delivery Services Transformation Initiative (DSTI), seeks improvement in four major areas: integrated delivery systems, innovative care methods, alternative payment models, and population-level healthcare services.

In plain English, this means that the CHA is moving forward with best-practices such as electronic health records to arm both providers and patients with up-to-the-minute information. In practice, electronic health records function the same way as a patient’s “chart,” only without the possibility of mistakes due to transcription errors or loss of paper records. Electronic health records also make it possible to instantaneously check patient prescriptions against known allergies, integrate lab results with x-rays and MRIs, and let patients bring their chart with them on a smart phone or any other connected device.

The DSTI program is another important step forward on the road toward affordable, high-quality health care for all. As the Governor has pointed out in the past, DSTI funds benefit our “safety net hospitals,” the caregivers who serve our most vulnerable communities, and it’s good to see that the proverbial cavalry has arrived to support our doctors and nurses. I will continue to fight for a single-payer health care system, but the transition of the CHA to a medical home model with the help of the DSTI program is an unequivocal win for our district and for our neighbors. I played an integral role in the creation of the CHA, and I’m proud that they’re continuing to find new ways to improve patient care.