Why Health Reform is Not Just About Health Care

Health

Here’s a quick exercise: imagine you need to find an important product or service for your family, but you are unsure of where start your search. Now close your eyes and imagine a “high-quality customer experience”, one that is “streamlined and integrated” and can “accurately and quickly make a decision about [your family’s] eligibility”. Ok, where are you? If you guessed the Department of Motor Vehicles, sorry, no (and keep dreaming)…but you are on the right track. This will be a consumer experience brought to you by the U.S. government. But how, you might ask? Through a little (ok, BIG) thing called the Patient Protection and Affordable Care Act (ACA), also known as health reform.

The ACA made the news once again (if it ever really left it) with this week’s announcement that the Supreme Court will hear a challenge to part of the 2010 health reform legislation. Despite these challenges, however, the country is marching ever-closer to the date of implementation (January 1, 2014) when most of the health care coverage expansions will take effect – including an expansion of Medicaid eligibility to non-elderly adults and children with incomes up to 138 percent of the federal poverty level (FPL), and refundable tax credits to help offset the cost of private health coverage for moderate-income families with incomes up to 400 percent of FPL. What is less obvious, but just as important, however, are the very real and very important opportunities afforded by the ACA to the non-health world.

Under the ACA, each state will develop and use an integrated, user-friendly process to determine families’ eligibility for health coverage or tax credits, enroll them in the proper plan(s), and keep them covered. Even better, this process will be based as much as possible on existing state and federal data, such as tax history, employment and wage data, and existing enrollment in other programs – thereby reducing not only paperwork hassles to families, but also the time spent waiting for notifications and a final response (records will be checked in real time, meaning many applicants will be able to receive immediate approval).

Now while this is undoubtedly a great leap forward for health coverage, why is this important for a family’s non-health needs? The ACA (in Section 1561) also envisions that – in addition to health care – this modern, streamlined system will be able to use much of the same original data to provide families access to a variety of human service programs, such as cash assistance, food stamps, child care assistance, and much more. Considering the fact that a family whose income qualifies them for Medicaid will very likely qualify for a host of other public supports, this is an unprecedented opportunity to reduce red tape for families and improve benefits access, while also reducing administrative costs.

But if this vision has any chance of becoming reality, it is crucial for state human services agencies and advocates to be as involved with the development of these systems (also known as Exchanges) as state health agencies and advocates already are.

To this end, the Coalition for Access and Opportunity (a collaboration of advocates, researchers, and practitioners headed by First Focus, the Center for Law and Social Policy, and Single Stop USA) has partnered with Stan Dorn of the Urban Institute to outline exactly what opportunities – including federal financial assistance! – the ACA offers to states to link up their health and human services programs. In addition to Dorn’s new paper, “How Human Services Programs and Their Clients Can Benefit from National Health Reform Legislation”, the Coalition has also developed an action toolkit, highlighting specific funding opportunities and action steps states can take to integrate IT systems, data collection, and program administration.

The ACA is a big bill, but it is full of opportunity, and not just for health coverage. Though if a truly integrated and seamless experience is to be realized for families, state agencies and advocates need to act now. Because if January 1, 2014 is the future, it is almost here.
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For More Information:

Read Stan Dorn’s new paper: “How Human Services Programs and Their Clients Can Benefit from National Health Reform Legislation”;

Take action with the Coalition for Access and Opportunity’s “Health and Human Service Integration Opportunity Toolkit”:

What is in the Affordable Care Act;
Short List of Opportunities for States;
Enhanced Federal Funding to Support Eligibility Systems Available for Limited Time;
Five Reasons to Integrate Human Services into Health Reform Now.

Read the federal guidance to states on developing integrated eligibility determination systems under the ACA.