Help us make sure the health care law works for people with MS

People with MS often have a difficult time finding a good health insurance plan that is affordable and comprehensive. Too often, plans either cost way too much or don't cover your MS drugs. Luckily, help is on the way. 

The Affordable Care Act created a new way for people to compare and purchase health insurance that fits your budget and meets your needs. The Marketplace (also known as an exchange) will allow you to fill out one application and you'll be able to compare plans based on price, benefits, and quality. 

To make sure the Marketplace (called HealthPlanFinder in Washington) works for people with MS, we need some people who are willing to be "user testers" of the new website. You'll have a chance to make sure that the particular needs of people with MS are considered. If this interests you, please let me know at jim.freeburg@nmss.org or (206) 284-4254, ext 40237. We are looking for testers available August 5-9 and 12-16. You'll need to travel to Olympia for a three hour session. 

Healthplanfinder will open October 1, with coverage starting January 1, 2014. Individuals outside of Washington can find their exchange at Healthcare.gov. 

Changes are coming to your health insurance

The Affordable Care Act was signed into law by President Obama three years ago tomorrow and we are on the cusp of the major changes taking effect. To help you get a better sense of what this means for you, I thought I'd share with you this recent press release from the Office of the Insurance Commissioner that summarizes these changes quite nicely. Read on.... 

OLYMPIA, Wash. – Three years after the passage of the landmark Affordable Care Act and Washington state is now on the cusp of the biggest health care reform in decades.

“We’re busy at the state and federal level, working behind the scenes to make sure that health care reform lives up to its promise,” said Insurance Commissioner Mike Kreidler. “But as we approach Jan.1, 2014, people want to know what the changes will mean to them.”

As early as October, you can start shopping for coverage in Washington state’s new online marketplace, the Healthplanfinder where it will be easy to compare plans, check prices, sign up for coverage and – depending on income – get help paying for it. Individuals earning up to almost $46,000 and a family of four earning up to $94,200 could qualify for subsidies.

“The financial help available through Washington’s new Healthplanfinder will be a lifeline for people who are uninsured or struggling to afford the coverage they have today,” said Kreidler.

To help you get ready for the coming changes, we’ve launched an expanded edition of our health reform website with specific information for individuals and families including:

·    Who has to have health insurance

·    Where you can buy it

·    How much it’ll cost

·    What it’ll cover

Additional resources for small businesses, large businesses and seniors will be added soon so check back often.  We expect to receive rate requests from health insurers for their individual and small employer plans starting in May on our health insurance rate transparency site. At that time, you’ll also see which insurers want to have health plans in the Healthplanfinder.

Sign up today to be notified by email if your health insurer requests a rate or benefit change.

The following reforms are already in place:

·      No out-of-pocket costs for preventive services,

·      Sick children can no longer be denied health insurance,

·      No lifetime caps on the amount an insurer will pay for covered benefits,

·      Young adults can stay on their parents’ health coverage until age 26,

·      And your health plan can’t be canceled, except if you lie on your application.

Other major reforms starting Jan. 1, 2014 include:

·      No one can be denied health insurance if they’re sick.

·      All individual and small employer health plans must cover essential health benefits, such as prescription drugs, hospitalization, maternity care and emergency services.

“The Affordable Care Act won’t fix everything that’s wrong with our health care system today,” said Kreidler. “I’m certain that just as we did with Medicare, we’ll need to make improvements. But the reforms in place now and those coming next year are a huge first step, and not a moment too soon.”

Legislative Update - Dodged the bullet this time...and had some wins!

As you know, the Legislature finished up a few weeks ago, and the results were a bit surprising given the place we started in December.  Amazingly, after some creative accounting, almost all of our priority programs were saved! This is partly due to the improved economy, decreased caseloads, and accounting maneuvers (whatever that means).  

We also saw great success with the passage of the Health Exchange bill (HB 2319)!  This is one more step in the implementation of the Affordable Care Act.  A very exciting development is the inclusion of a trigger that will allow the Insurance Commissioner’s office to address the specialty tier issue if it causes adverse selection in the exchanges. Listing critical drugs in the “specialty” tier frequently puts these necessary medications out of reach of many people living with MS. If you have a story about your experience with “specialty” tiers, please contact the chapter to share your story so that we can show our representatives that their constituents are suffering due to this unfair practice.

http://www.nationalmssociety.org/chapters/was/advocacy/tell-us-your-story/index.aspx

The Greater NW Chapter has been included in a task force contributing to establishing the minimum standards for the state Health Exchange network. This is a significant place at the table for the MS Community, as we are communicating the needs of the chronic disease community and establishing a consumer centric Health Exchange that will serve the needs of the consumers who truly need this service.

Over the last several months, we have joined forces with coalitions, such as Healthy Washington and the Long Term Care group/Aging Caucus, to help get our message across to our legislature. The passage of the Health Exchange bill proves we are definitely more effective when we join forces with other groups.  

We are thankful that our programs were “saved”, but after all of the cuts over the last several sessions, there isn’t much left to save. Now we need to focus on improving our safety net programs so that the needs of our community are served. Keep up the pressure on your state Legislators (http://apps.leg.wa.gov/DistrictFinder/Default.aspx ) to protect and improve Basic Health, Disability Lifeline, and Medicaid so that that people living with MS will have access to the services so desperately needed.

 It’s Time for Action! Washington

Cheers! – Holly Hawker

Chair, Activism Committee
Greater NW Chapter, National MS Society

Advocacy: speaking out on behalf of an individual or community

Advocacy takes place in many shapes, forms, and colors. Sometimes it's sticking up for yourself when your insurance company tries to deny your claim or your family members disagree with your decisions about how to take care of yourself. Sometimes you advocate for yourself, sometimes you advocate for others.

When you advocate for yourself and others at the same time, it's an especially powerful statement. Check out this recent letter to the editor about someone who is sticking up for herself and the MS community in voicing her concerns about recent proposals to cut Disability Lifeline - an important health care program for people living with MS.

How do you advocate? If you are looking for a way to advocate, check out this Action Alert that makes it easy to share your voice with elected officials.

Washington's budget becomes a little more clear...

Down in Olympia, the House Majority released its draft budget this morning. We are still analyzing it to see how it lines up with our priorities, but from a first glance, it's good news. The budget retains Basic Health and Disability Lifeline, and refrains from making major eligibility cuts to long term care. Budget writers have seen good news in recent weeks with an increase in available funding due to increased tax revenue and a decrease in demand for state services.

The Senate will release its draft budget shortly and then the two chambers will negotiate to come up with a final budget. All indicators point towards the legislature getting out on time, finishing up on March 8, though there is still plenty of time for that prediction to change.

If you are curious what an actual state budget looks like, check out the highlights, the agency break down, and the budget bill.

This afternoon, MS Activist Veronica Chase will be traveling to Olympia with me to share her perspective on the House budget. The hearing starts at 3:30pm and can be viewed online. We expect a packed house as other organizations like our own share their thoughts on the budget as well.

On Friday, I mentioned that I'd be testifying in favor of the health insurance exchange bill in the Senate Health & Long Term Care Committee. Yesterday's hearing saw a packed room and a long list of people wishing to testify. As such, we ran out of time before I could share my testimony, but there were many people in the room who shared our sentiment. Check out the hearing below - there were some very heated exchanges over the course of the hour plus hearing:

What a day in Olympia!

For those of you who missed it, the Day of Activism on January 30th was incredibly informative and motivating! Between the excellent guest speakers, the education we received on the legislative agenda, and the surprising dry weather, the group of about sixty activists were ready to tackle the issues with our legislatures.

As you have seen in previous posts from last week, SB6241/HB2435, the bills aimed at Capping Out of Pocket Expenses are gaining traction! The testimony at the public hearing was attended by a coalition of consumers (including representatives of the Greater Northwest Chapter of the National MS Society) sharing their stories and the impact that the costs of chronic illnesses have on their lives. Please share your story with your representatives and let them know that you support these bills.

The National MS Society has also thrown its support (along with Healthy Washington Coalition) behind consumer driven development of the Health Insurance Exchange required by the Affordable Care Act in 2014. It is crucial that the exchanges are developed to serve the consumer and patients’ interests and not hi-jacked by the insurance companies.

As we have for the past few years, we were again begging our legislatures to STOP the CUTS to the state’s safety net programs. With Basic Health, Disability Lifeline, and aspects of Medicaid on the line, NOW is the time to take a stand. Did you know the state is considering ending the prescription benefits for Medicaid? That alone will devastate the MS Community.

Right now is when your legislators need to hear from you! Call 800-562-6000, visit, or email http://www.leg.wa.gov/pages/home.aspx (click here to find your legislators) and let them know that they MUST protect the state safety net programs!

Stay tuned for updates on the current legislative session and what to follow for the upcoming election in November. It’s Time for Action! Washington.

Cheers - Holly