For IPF:
dstupar@ipfweb.org
Phone: 1-888-880-8222
Fax: 202-347-7339

For IHF:
rdonovick@bacweb.org
Phone: 1-888-880-8222
Fax: 202-383-3905

620 F Street, NW
Washington, DC 20004
202.783.3788

About Us

 

Issue 5, 2016

 

BAC Members Benefit From Affordable Care Act

Looking back to the past six years, Americans have a lot to be thankful for. The passage of the Affordable Care Act (ACA) in March 2010 provided access to care that many citizens looked at as a luxury. Millions who were uninsured struggled to pay for healthcare, with individuals with preexisting conditions literally locked out of the private insurance market. Many of those  who were insured risked losing it when they needed it most by hitting annual or lifetime maximums (The Center for Consumer Information & Insurance Oversight, 2016, www.cms.gov).  Fee for service encouraged providers to focus on the quantity of care they provided, rather than quality outcomes. The ACA changed all that. On March 31, 2015 nearly 10.2 million Americans received coverage through the Health Insurance Marketplace. As a result, the largest reduction in uninsured has occurred in four decades with 16.4 million uninsured individuals now having coverage through the Marketplaces and employer based plans due to increased age of dependent children to age 26 and Medicaid expansion (The Affordable Care Act is Working, 2016, www.hhs.gov).

In addition to insuring more individuals, the ACA has also made healthcare affordable.  Of the 10.2 million people who paid premiums and had active Marketplace coverage on March 31, 2015, nearly 85% nationwide have received an average premium tax credit of $272 per month (The Affordable Care Act is Working, 2016, www.hhs.gov). According to a Commonwealth Study, this has resulted in fewer problems for Americans with paying medical bills.

For individuals already covered under a group health plan, the ACA has reduced out of pocket costs by ensuring that preventive services are covered at no cost to individuals and their families.  Dollar limitations once used to shift costs to members by capping how much a plan can pay are no longer allowed on essential health benefits; starting in 2014, the law banned annual dollar limits. This means plans cannot have annual dollar limits on coverage of essential benefits, such as hospital, physician and pharmacy benefits (The Center for Consumer Information & Insurance Oversight, 2016, www.cms.gov). Benefits materials must be summarized in a uniform and linguistically appropriate format (Summary of Benefits and Coverage and Uniform Glossary, 2016, www.dol.gov).    

In addition to the ACA, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) improved Behavioral Health coverage. MHPAEA is a federal law that does not apply directly to small group health plans, although its requirements are applied indirectly in connection with the ACA’s essential health benefit requirements. It generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. (The Mental Health Parity and Addiction Equity Act, 2016, www.cms.gov).

The International Health Fund (IHF) has implemented all of the required changes to most of the plans offered in our Private Exchange. Plans in the Exchange focus on access to ambulatory care such as doctors’ visits and do not put excessive cost sharing requirements for our members to access prescription drugs. The IHF has implemented benefit designs and care coordination programs that provide members both quality and choice and has continued to grow as a result. IHF also welcomes Local 1 UT members into the IHF effective April 1, 2016. On this page are just a few comments from our members about the healthcare exchange programs.

What BAC Members Say About the Affordable Healthcare Act:

“Everyone should have the opportunity for insurance.”

“It will help a lot of people.”

“I approve [the Affordable Care Act], especially for those who don’t have jobs.”

“I have enrolled. Compared to the union’s insurance it’s inferior but it’s better than nothing.”

“I have it (healthcare exchange) now. I do not qualify for the union’s insurance.”

“Anything to help people, especially if they get sick.”

If you have any questions about IHF’s exchange programs, please contact IHF at 202-783-3788 or email IHF Executive Director Robin Donovick at rdonovick@ bacweb.org.