In King v. Burwell, the United States Supreme Court had to decide on the newest challenge to the Affordable Care Act (“ACA”).  As stated in my first post, King argued that, as written, the ACA only provides support to states that set up their own exchange.  On the other hand, Burwell argued that the ACA meant to treat all health exchange markets the same, whether state-managed or not.

On July 25, 2015, the Court issued their opinion and ruled in favor of Burwell, saying that Congress meant to treat all exchanges the same.  This ruling means that those Hoosiers who received aid from the government to help purchase a health plan under the Federal Exchange will be able to keep this aid.

The 6 Justices who ruled in favor of Burwell explained that the words “established by a state” really meant to include Federal Exchanges as well.  Their 21-page ruling argued many points to help build their case, but one of their most basic points was that the ACA would fall apart if they read those words in favor of King.

King v. Burwell Broken Down

To help clarify this case, let’s think of the ACA as a 3-legged stool.  Each of the 3 legs, which are listed below, relies on the other in order hold the ACA up.  If one leg falls, however, then the entire stool will also fall over.   There are three key points, or legs, which make the ACA stand up:

1. People are given government aid (tax subsidies) to purchase a health plan.
2. The ACA says people must have insurance or pay a fee;
3. Insurance groups must accept every person in the State that applies for a plan, even if sick;

The Court said that if the ACA was read in favor of King then the ACA would collapse.  The points below make up what the Court called the “death spiral” of King’s argument.

1. No person in a federal exchange state would get any government aid in buying a plan.
2. If no one got any government aid, then many would not have to purchase any insurance at all, since the ACA says it would cost too much (over 8% of income).
3. If no one bought insurance, then insurance groups would have to a lot charge more money and many more people would lose coverage.

Conclusion

The Court said that Congress would not have meant for this “death spiral” to happen.  Congress would only pass the ACA in order for it to work; they would not have passed it if it was doomed to fail.  This is one of the many key reasons that the Court again found the ACA legal.  This was the second time the ACA has been in front of the Supreme Court, and the second time that it has been upheld.

Post by Dan Wegg

What does this mean for Indiana?
If the court agrees with King, over 200,000 Hoosiers may lose the money they received to help purchase their health plan, along with millions of Americans.[iii]  If the court agrees with Burwell, then all money that was received to help buy a health plan will be seen as legal and no one will be at risk for losing their support.

What will happen if King wins?
If King wins, Congress could slightly change the law to fix the problem. Although not likely, this would be the fastest option.  It could also fall on each state to fix the problem, for example, by setting up a new exchange. This, however, could cost a lot of money. We will hear a lot more about a fix in the coming months if the court rules in favor of King.[iv]

How will the Supreme Court decide?
The Supreme Court is made up of 9 Justices.  So far, 4 Justices seemed to side with the Burwell, while 2 seemed to side with King.  If this is the case, then Burwell only needs the support of one more Justice in order to save the ACA as it is written.[v]  Though this seems a bit more likely than not, it is very hard to say how this court will rule. We are looking for the ruling in late June; I’ll provide an update once more news is received.

Post by Dan Wegg, Corporate Affairs Manager

In August of 2013 a change started to take place. HealthNet staff were given the opportunity to train as Federal Navigators to help people enroll in the Market Place under the Affordable Care Act.  After many hours, weeks, and months our team all became official “Navigators”. So what does that mean?

For the first month we waited patiently for referrals (people interested in signing up for health insurance).  As a way to increase referrals, the Outreach and Enrollment Team attended staff meetings at each HealthNet Center to explain the health insurance referral process.

As navigators we meet with individuals who are in need of health care insurance for FREE. These individuals, who become our clients, can need  different types of health insurance, such as the Marketplace, Healthy Indiana Plan or Medicaid. The Navigators will meet with clients to discuss their health insurance options ANYWHERE that is convenient for them (even McDonalds)! Navigators might show up thinking they are going to do one enrollment and end up doing 3 or 4, because other people in the household need insurance as well.

As Navigators we “navigate” clients through the health insurance enrollment process.  We help clients understand what plans they qualify for and give them follow up information to check on their enrollment status. The enrollment time varies with each client. As Navigators, we have the flexibility to take extra time to meet with clients if needed since we are located throughout the community.

Where the Outreach & Enrollment Team is now is a big change from those first couple months. There are now seven certified Navigators on the Outreach and Enrollment Team and we are still growing. We have two bilingual navigators and are steadily receiving referrals. We are receiving more training on a regular basis to ensure that all clients are served regardless of their need. We have laptops, printers, shirts, jackets, and cool rolling bags to carry it all in. So if you see someone coming through the clinic looking like a pilot on a mission with a bag rolling behind them that would be a Navigator. As Navigators, we will meet you anywhere in the community that is convenient for you.

The enrollment period ends on March 31, 2014! If you or someone you know is in need of our free services please call:

317-957-2676
insurance@indyhealthnet.org
www.indyhealthnet.org 

]]> http://blog.indyhealthnet.org/late-sign-health-insurance/feed 1 http://blog.indyhealthnet.org/improving-access-care-indys-west-side?utm_source=rss&utm_medium=rss&utm_campaign=improving-access-care-indys-west-side http://blog.indyhealthnet.org/improving-access-care-indys-west-side#comments Tue, 29 Jan 2013 19:22:21 +0000 giveacareindy http://blog.indyhealthnet.org/?p=3480 In Indy, we take pride in our neighborhoods.

From Martindale-Brightwood to Downtown, Fountain Square to Brookside or Broad Ripple, we appreciate the personality and flavor of each small community.

At HealthNet, we’ve been deeply invested in our neighborhoods for more than 45 years.

In fact, many of our health centers began with small groups of residents working to bring health care to their communities, when they didn’t have any doctors nearby. Creating a health care home starts right in our own neighborhoods, with primary care providers who maintain long-term relationships with their patients.

This month, we joined our eighth community and became a West 10^th Street neighbor!

The new HealthNet West Health Center opened full-time at 10^th St. and I-465, and will serve more than 3,000 people each year. HealthNet West is really an outgrowth of Southwest Health & Dental Center, which has been serving the West Side community for 41 years!

The outpouring of community support for HealthNet West has been tremendous.

We’d like to thank the West Side Chamber of Commerce, the Speedway Town Council, the Speedway Chamber of Commerce, IU Health West Hospital and all the civic groups, churches and schools that have welcomed us to West 10th St. Check out these photos from this month’s Grand Opening Community Celebration!

Learn more about the new HealthNet West Health Center!

The first half of the year really has been a load of content that mixed some patient and staff stories along with our thoughts on current events that have occurred locally, state-wide, and even nationally. 

However, I think it is time to properly introduce ourselves, and that will happen in this four-day blog series ‘4 Days until July 4^th weekend’. 

This series will give you the gist of HealthNet, Inc.’s outreach programs that really bring wrap-around services to our network of health centers.

Now without further adieu,
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Part One: Homeless Initiative Program….

Since 1988, our Homeless Initiative Program (that hopefully you will grow to know as ‘HIP’) has helped thousands of Indianapolis’ homeless by providing a network of services to treat the whole person, as he or she moves from homelessness into employment, housing, and self-sufficiency. 

HIP’s mission is to assist homeless persons in reaching a level of self-sufficiency consistent with their goals and capabilities for physical, mental, social and economic well-being.

And to stick with the number 4, here are four things you need to know about HIP:

1. HIP serves nearly 3,300 homeless individuals per year.Through a wide array of services that include employment and training, case management, triage/outreach, health care services, and a homeless veterans reintegration program, HIP gives a care about the specific needs of the individual on a case-by-case basis.
2. HIP is one of the largest, most comprehensive homeless programs in the state.HIP staff work closely with other providers around the city to continuously stay up-to-date on all community resources available for homeless individuals.  HIP builds partnerships that work because ending homelessness is a team effort.

    

3. Persistent staff work tirelessly on a case-by-case basis.I can’t put the right amount of emphasis on this in two sentences. So, here are two links to previous blogs:
   - Jeff Smith, a homeless veteran who became an alcoholic and was convicted of forgery, received a second chance because of the persistent effort of his biggest advocates — the HIP staff
   - Ricky Wallace, a homeless veteran who wanted to help his ailing parents, moved to Indy thinking he could crash with a friend. But his plans fell through.  HIP helped Ricky find emergency housing and now he is living his dream as a chef.
4. There are plenty of ways to get involved.Here are just a few examples of how you can help prevent and end homelessness without a monetary donation.  However, donations are accepted and much appreciated because of the continual struggle to find funding for homeless services each year!  Also, time is money. Call here to learn about volunteer opportunities with HIP.

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Want to learn more about HIP?
Are there specific questions that you have about homelessness in Indy?
Comment below!
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[T]his major reduction will — in this year alone — negate the ability to provide basic health care services to over 5 million of our most vulnerable Americans, and will seriously undermine the ability of health centers to provide services to 40 million people by 2015.” – press release from the National Association of Community Health Centers

This cut in health center funding has received mixed feelings from people everywhere.  The good thing is that, according to Congressional summaries, no health center SHOULD have to close its doors and funding to continue services as is will remain.  However, with the good, comes the bad.  Community health center expansion is halted. This will affect the millions of people in this country who, today, cannot access basic primary and preventive health care services in their local communities. It also affects health care costs, as these underserved communities must continue relying on expensive visits to the emergency room for their basic primary care. With cuts in appropriations, the Department of Health and Human Services will have to redirect funds from the Affordable Care Act in order to simply maintain operations as they are today.

Feel free to research the links above to learn more about the state of the Health Center Program TODAY, but as advocates giving a care about health centers in Indianapolis, the state of Indiana, AND throughout our nation, we need to keep forging ahead.

Here are three ways to help community health center expansion despite the funding cuts.

1.  Continue to call, email, and fax letters to your legislators
   - Remind your Representatives and Senators that even the slightest setback will not discourage us from emphasizing the importance of health center funding.  This will give us more clout and respect as an advocacy group, and our Congressmen will have to continue to take us seriously.
2. Educate your friends and family about community health centers.
   - Plenty of people STILL do not understand the mission and role of community health centers.  Spreading the good news of the work done in our centers, the money the health care system saves, and the number of lives touched by FQHCs can only help gain more advocates who will be easily persuaded to sign a petition or send and email when called upon to do so.
3. Keep working with the same amount of passion.
   - Whether you are a front desk worker, a physician, a nurse midwife, or finance staff person, continue to approach your job with the same passion day in and day out.  Our funding may have been cut, but that should not mean that our quality of care has been cut. The passion of CHC staff is what makes advocacy easy!

 What is one project that you would like to see done to help with Health Center Advocacy?  Share your ideas below!!

One year ago tomorrow, President Obama signed into law the Affordable Care Act.

Community Health Centers now serve 23 million patients and provide care for one-fourth of all primary care visits for low-income citizens in our country.  The Affordable Care Act has been one more step towards health centers throughout the nation caring for 40 million patients by 2015.  The two greatest statistics that show the effectiveness of community health centers are

1. Cost per patient per day is nearly a dollar lower than all physician settings ($1.67 v. $2.64)
2. Medicaid beneficiaries who choose health centers for primary care are 19% less likely to use the ER for unnecessary visits and 11% less likely to be hospitalized.

The expansion of HealthNet’s Southwest Health & Dental Center, People’s Health & Dental Center, and the soon-to-be Barrington Health & Dental Center has benefited the Indianapolis area greatly.  These expansions will allow HealthNet to reach a greater number of underserved areas and provide services to more patients who otherwise would go without primary and preventative health care or unnecessarily use the ER.

However, there are still areas of HealthNet (not supported under ACA) that need expansion.  Areas such as

• Homeless Initiative Program – serving more than 3,200 homeless persons in Indianapolis
• Better Indy Babies/Healthy Families – making more than 14,720 visits to families in at-risk homes in Marion County
• Social Services – providing support to families living below the poverty level which is one in every 16 people in Marion County
• Radiology/Mammography Assistance – helping uninsured women who are less likely to be screened for breast cancer
• School-based Services – assisting more than 3,320 students in receiving health care and health education in 8 public and charter schools in Marion County
• Health Promotions – a free service that includes a dietitian, tobacco cessation counselor, and childbirth specialist

In light of the one-year anniversary of the signing of the ACA into law, we want to highlight the successful expansion of our community health centers throughout Indianapolis, but also ask for our COMMUNITY’S help in expanding our outreach services to reach further and build a healthier neighborhood for everyone.

You can help us reach those in need by making a quick donation online or by mail.  Visit our donation page to learn more about these programs and ways to assist HealthNet