Tag Archives: aca

Women’s health coverage improved


| aaltman@queenscourier.com

Forty-seven million women just got healthier.

On August 1, preventive benefits for women, including breast and pelvic exams, HPV and HIV testing, gestational diabetes screenings and contraceptives became available, co-pay free, to all insured women.

“I think it’s great,” said Pauline Compton, an accountant from Bayside. “I think all women should be entitled to co-pay free health services, just like men. I don’t think there should be anything held back as far as health care goes. Preventive care is the best thing, and it should not be limited to anybody.”

These benefits became available to women through the Patient Protection and Affordable Care Act (ACA), signed by President Barack Obama in March 2010. Before August 1, the reform included only mammograms for women over 40 and osteoporosis bone-mineral-density screenings for women over 60.

“We see the need for affordable health care every single day,” said Cecile Richards, president of Planned Parenthood Federation of America. “For the one in five women who relies on Planned Parenthood at some point in her life, the preventive benefits that began rolling out [August 1] will help ease the struggle of deciding whether to pay for birth control or pay for textbooks, groceries or gas for the car.”

Under the ACA, women will no longer be required to pay more than men for health insurance and people with pre-existing conditions, including cancer, cannot be denied coverage.

The new reform also includes counseling for victims of domestic violence.

According to the U.S. Department of Health and Human Services (HHS), women employed by certain religious organizations with health care sponsored by their employers are exempt from the coverage requirement.

Additional reporting by Adrienne Kurtz

Affordable Care Act’s impact on small biz


| lguerre@queenscourier.com

At a recent business workshop local small business owners and employees learned that although the Affordable Care Act (ACA) will give them necessary health coverage, it may come at a high price.

Sher Sparano, president of the Benefits Advisory Service, broke down the law’s effects on small businesses to nearly a dozen uncertain and bewildered professionals at the event, which was hosted by the Queens Chamber of Commerce on July 20.

“Our goal was for people to walk away with a sense of how to prepare,” Sparano said. “They need help and guidance along the way as the law changes.”

Although businesses with fewer than 50 employees are not required to provide insurance for their workers, they are still urged to make sure their employees are covered.

To encourage these small businesses to invest in insurance for their companies, those with fewer than 25 full-time employees averaging $50,000 yearly, could apply for a 35 percent tax break. That will increase to 50 percent in 2014.

Unfortunately, only 170,000 out of 4 million possible businesses applied since 2010, and Sparano says that has to change.

“That’s one of the things we told small businesses, to understand that if they were entitled something, get it,” Sparano said. “I don’t care if they’re going to give me back $500. You have to apply to see if you’re going to get this credit.”

In 2014, New York will establish its exchange, or state-run list of insurance options. Small businesses will be able to provide coverage to their employees at lower costs through these lower priced plans.

Business expenses will rise to provide insurance, but it may be an essential step for health care reform.

“There are a lot of small businesses today that don’t give health insurance and that will change,” Sparano said. “If we want the health care act to succeed it has to happen like this.”

Through ACA, a state could choose whether or not to expand its Medicaid system. Governor Andrew Cuomo elected to increase New York State’s system, which will make more people eligible to access Medicare.

Individual Americans who make about $15,000 a year and families of four that earn $30,000, will be able to get Medicaid, up from approximately $9,000 and $15,000 respectively.

Sparano mentioned sections of the law that will go in effect soon, such as insurance carriers expanding no-cost preventive services for women, and companies providing summaries of benefits and coverage and notifying employees about the state-run exchanges.

Also on August 1, customers will receive Medical Loss Ratio (MLR) rebates. MLR rebates are distributed when insurance companies spend less than 80 percent of premiums on medical care for plan holders instead of administration, like salaries and marketing.

When businesses get the rebates they will distribute the money proportionally to workers enrolled in company health plans, according to how much their plans cost.

“The most practical information I learned was about the rebates,” said Phil Robinson, an employee for Petracca & Sons construction company in Flushing. “In my mind it was just a check that would arrive at the employee’s house.”

MLR rebates will give nearly 12.8 million Americans more than $1.1 billion this year, according to the Department of Health and Human Services.

Towards the end of her presentation, Sparano recommended that smaller businesses that want to provide health insurance and save money adopt wellness programs.

“The healthier the population is the better the experience would be,” Sparano said. “It lowers the premium, and you get better more productive hours out of your staff.”

To your health


| brennison@queenscourier.com

It’s like the 1960s all over again.

As the United States Supreme Court upheld parts of President Obama’s Affordable Care Act (ACA), it harkened back to June of 1965, when the country — and our bipartisan elected officials — were divided over Medicare.

With a Cold War mentality, many feared that Medicare meant socialism — and the end of freedom as they knew it.

Today, millions of seniors depend on the coverage afforded them by Medicare, and claims the system is going bankrupt have spurred fears — and talks on how to keep Medicare solvent for an aging population.

We feel the Supreme Court’s ruling that ACA is constitutional transcends partisan politics and concerns itself with the people.

And that’s the bottom line.

All people should have access to health insurance, regardless of income, age, race — or existing conditions.

The ACA does just that.

By creating a “health care exchange,” individuals and small business owners will be able to select from a range of affordable heath care options.

Through these exchanges individuals with pre-existing conditions will not be charged higher rates and they won’t lose coverage if they get sick.

All businesses, except those with fewer than 50 employees, will be required to provide insurance to their workers.

But small businesses under the cut line — 340,000 which are eligible in New York — that do offer insurance can quality for a 35 percent tax credit, which will increase to 50 percent in 2014 if they enroll through the exchanges.

Going forward, companies can no longer impose lifetime limits on care or charge higher rates for children with pre-existing conditions.

And young adults that already receive coverage through their parents can remain on those plans until the age of 26.

Starting in August, insurance companies will also be required to cover women’s preventive services, including contraception.

What this all means, we feel, is that power has been given back to the people.

No longer will families fret over mounting medical bills.

No longer will parents of children born with conditions be forced to file bankruptcy — just to ensure their child gets the medical attention he or she needs.

And no longer will American people have to choose between a medical procedure or food on the table.

What this is is not socialism — it is the beginning of a healthier, fairer America.

Affordable Care Act: What it means for immigrants


| lguerre@queenscourier.com

When Sunnyside resident Blanca Palomeque had ovarian cancer two years ago she didn’t have full health insurance to cover her treatment.

She enrolled in the Medicaid Spenddown program, but it only provided her with six months of assistance and she was forced to pay $15 out of pocket for each visit to Elmhurst Hospital and $150 for each CAT scan during the next year-and-a-half of her battle.

Even after winning the war with the disease earlier this year, Palomeque, 49, still didn’t buy an insurance plan.

“I don’t have medical care, because it’s difficult to have it,” Palomeque said. “I don’t qualify for Medicaid health insurance, because my income is a little too high, and it’s difficult to afford private care.”

Instead, Palomeque, who emigrated from Ecuador 11 years ago and is a documented immigrant, prefers to pay for hospital visits instead of committing to a plan.

However, like many Queens immigrants, she is rejoicing after the Supreme Court’s recent approval of the Affordable Care Act (ACA), praising its expansion of the health care system, which will benefit legal residents and may even help undocumented immigrants. “I think it’s a really good idea, because now the community will be able to act fast on health insurance,” Palomeque said. “Sometimes people have illnesses that last a long time and it’s really difficult to go and pay each time.”

“As an organization we believe that it’s a step forward, because it opens up access to health care and health insurance to many people who are uninsured,” said Theo Oshiro, deputy director of Make the Road New York, which is a non-profit organization that predominately supports Latin immigrants in the city.

Of the approximately 2.2 million residents living in the borough, nearly 50 percent are foreign born, according to the 2010 Census, and documented immigrants will receive the same benefits from the act as native citizens.

This means they won’t have to worry about getting insurance if they have pre-existing conditions, and now their children can remain on their current plans until age 26.

Documented immigrants must also follow the mandate that requires everyone to have insurance or face a tax.

But if they don’t already have insurance or qualify for Medicaid, they will be able to purchase health care from the state-run “exchanges,” or collections of low rate insurance options when they become available in 2014.

“They just have to worry about everything they worried about before,” said Stan Mark, senior staff attorney for the Asian American Legal Defense and Education Fund. “They have to struggle to get the minimal health care option that they can get.”

New York, which was one of the states that chose to expand its Medicaid coverage through ACA, will receive more than $2 billion in federal funding starting in 2014, and many immigrants will continue to receive care from it.

Immigrant groups officials say the down side to ACA is that it none of its benefits are available for undocumented immigrants, which could upset many foreign born residents.

But the law will affect them.

In 2003 Mayor Michael Bloomberg issued executive orders, (EO) 34 and 41, which replaced former Mayor Ed Koch’s EO124, but kept the same concept to protect immigrants.

The order “Ensures that all New Yorkers, regardless of immigration status, can access the city services that they are entitled to receive.” In addition, “City workers must protect the confidentiality of a person’s immigration status,” unless that person is suspected of illegal activity.

It was established so that undocumented immigrants would report crimes to the police, call firefighters, get medical treatment or send their children to school without fear of deportation.

Because of EO 34 and 41, undocumented immigrants have received care from public hospitals under the Health and Hospital Corporations (HHC), such as Elmhurst Hospital or Queens Hospital Center, and will continue to do so.

“For generations New York has been known as a city of immigrants, and for generations the public hospitals have cared for New York’s immigrant populations,” said HHC President Alan Aviles. “It is important to remind immigrant New Yorkers that they can get quality health care in our city without fear.”

What the Supreme Court’s decision on the Affordable Care Act means to Queens


| lguerre@queenscourier.com

Last week, President Barack Obama’s landmark legislation to supply health care to most Americans was upheld by a 5-4 Supreme Court ruling, and soon many uninsured Queens residents will have access to doctors, hospitals and preventive medicine.

The constitutionality of the Affordable Care Act (ACA), which was passed in 2010, had been questioned by lawmakers because the law mandated that all Americans have health care or pay a fee.

However, Chief Justice John Roberts, who was appointed by former President George W. Bush, gave the surprising tiebreaker vote to upholding the law, deeming the penalty a tax, which Congress is normally allowed to enact.

“The courts looked at it in a constitutional manner and agree that what we did was constitutional,” said Congressmember Gregory Meeks, who represents parts of southeastern Queens. “The president’s achievement and what the Democratic controlled congress did is the right thing for America.”

Officials said the historic decision from the nation’s highest court will especially affect locals.

“The Supreme Court ruling to uphold significant sections of the patients’ bill of rights is a momentous feat for the future viability of Queens’ health care,” said Assemblymember Andrew Hevesi, who sits on the Health Committee. “It is my hope that the reforms contained in the patients’ bill of rights will not only ensure the health and well being of our borough’s residents, but also enable us to expand our health care system in Queens”.

However, directly after the courts’ decision, local Republicans sided with party leaders, disclaiming the law’s benefits, and continuing bipartisan bickering over the controversial issue.

“Like most Americans, I am disappointed with the Supreme Court’s ruling today. ‘ObamaCare’ is expensive, expansive and unpopular,” said Councilmember Dan Halloran. “Even in upholding ‘ObamaCare,’ the Supreme Court held that it’s a tax — the biggest tax increase in American history. That’s the last thing we need in these economic times.”

But Obama later defended the mandate, citing two reasons.

“First, when uninsured people who can afford coverage get sick, and show up at the emergency room for care, the rest of us end up paying for their care in the form of higher premiums,” Obama said. “And second, if you ask insurance companies to cover people with pre-existing conditions, but don’t require people who can afford it to buy their own insurance, some folks might wait until they’re sick to buy the care they need — which would also drive up everybody else’s premiums.”

To many people, ACA may seem confusing, because the law covers a significant range of changes in the insurance industry.

To break it down, the law forces insurance policies to become more secure and flexible for citizens that already have insurance.

Going forward, companies can’t impose lifetime limits on care or charge higher rates for children with pre-existing conditions.

Also, young adults that already receive coverage through their parents — approximately 77,800 of which are in New York — can remain on those plans until the age of 26.

In addition, starting in August, insurance companies will also be required to cover women’s preventive services, including contraception.

The law especially targets the more than 30 million Americans citizens that don’t have insurance by offering cheaper options.

These options and their prices will be clear by 2014, when each state will set up a range of affordable insurance choices in a marketplace known as “exchanges.”

With more than 2.7 million currently uninsured residents in New York, Governor Andrew Cuomo established the New York Health Benefit Exchange in April, which will affect more than one million uninsured New Yorkers.

“We will continue to move forward with implementing the health exchange that will lower coverage costs for New York’s businesses and help ensure that uninsured New Yorkers have access to health care,” said Cuomo after the court’s decision.

Through these exchanges, individuals with pre-existing conditions will not be charged higher rates and they won’t lose coverage if they get sick.

All businesses, except those with fewer than 50 employees, are required to provide insurance to their workers.

But small businesses under the cutoff –340,000 of which are eligible in New York — that do offer insurance can quality for a 35 percent tax credit, which will increase to 50 percent in 2014 if they enroll through the exchanges.

Although the legislation has been upheld by the Supreme Court, officials in the Republican-led House of Representatives have vowed to trash the law in a vote on July 11, according to published reports.

Local Democrats are calling the ruling a sign that it’s time to move on.

“Republicans must act in the interest of Americans now, and put the politics aside,” Meeks said. “Instead of rhetoric about repealing the ACA, it is time for Republicans to work toward successful implementation.”

Politics aside, some locals in the business industry are saying now that the law has been upheld it’s time to work.

“The next three or four years is going to be a lot of work,” said Sher Sparano, president of the Benefits Advisory Service. “Now we have gotten over the hurdle of ‘does the law exist,’ now we have to roll up our sleeves and figure out the details of how the employers and employees move forward.”

 

Queens politicians react to Affordable Care Act


| brennison@queenscourier.com

Just after 10 a.m. the Supreme Court handed down its ruling upholding President Barack Obama’s health care plan.

The court ruled 5-4 that the Affordable Care Act was constitutional.

Shortly after the decision, Queens politicians took to Twitter to comment on the ruling. Here’s a collection the pol’s reactions:

Congressmember Gregory Meeks: “ACA ensures children and young adults will stay on their parent insurance until age 26. ACA means that seniors are paying less for their prescription medication. With this decision, Americans will continue to benefit from the expanded access to quality, affordable health insurance.”

Congressmember Carolyn Maloney: “Today’s SCOTUS decision is one of the most historic in our lifetimes and a huge win for the American people. Proud to have helped pass ACA.”

Congressmember Joe Crowley: “Thrilled SCOTUS upheld health care law! Great victory for the American people!”

Congressmember Steve Israel: “By upholding the ACA, the Supreme Court has ensured that millions of Americans will benefit from critical consumer protections.”

Senator Kirsten Gillibrand: “Very pleased SCOTUS upheld Obamacare. Middle class needs access to affordable care and deserve the important benefits this law provides.”

Congressmember BobTurner: “Today’s SCOTUS ruling is a shame for Americans, small businesses and all in need of care.”

Congressmember Nydia Velazquez: “SCOTUS’ health care ruling ends health discrimination against women and means children with preexisting conditions are not denied coverage.”

Governor Andrew Cuomo: “The Affordable Care Act will provide access to health care to millions of Americans nationwide ans more than 1 million New Yorkers.”

Council Speaker Christine Quinn: “The Supreme Court’s decision to uphold the Affordable Care Act is great news for our city, state and nation.”

Public Advocate Bill de Blasio: “Hear that? It’s 43 million Americans breathing a sigh of relief, Affordable Care Act upheld.”

State Attorney General Eric Schneiderman: “SCOTUS decision to uphold the Affordable Care Act is an historic victory for the 32 million Americans who will gain health care coverage.”

Assemblymember Hakeem Jeffries, who is running for Congress in the 8th District which includes parts of Queens, issued a statement on the ruling.

“The Supreme Court has spoken and President Obama’s historic health care reform is now the law of the land. As I said during my campaign, I plan to go to Washington to work with the president, and one of my priorities is making sure that this new law is implemented fairly and effectively. I am also hopeful that Congressional Republicans will end their single-minded attempts to overturn or weaken this landmark law. With so many other challenges facing us, Congress needs to start its work on issues that will move our great nation forward.”