Senator Berta Gardner

September 19, 2013

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Serving Midtown, Spenard, and UMed

716 W. 4th Ave. Suite 340
Anchorage AK, 99501
 
Phone: 907-269-0174
Fax: 907-269-0177
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D.C. DELEGATION

Senator Mark Begich
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EMAIL: Sen. Mark Begich

Senator Lisa Murkowski
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EMAIL: Sen. Lisa Murkowski

Congressman Don Young
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EMAIL: Rep. Don Young

A Better Way to Manage Health Care

Dear Friends and Neighbors,

Senators Gardner and Wielechowski attend the UAA Engineering Building Groundbreaking Ceremony
Senators Gardner and Wielechowski attend the UAA Engineering Building Groundbreaking Ceremony

           Some months ago my twenty-something son told me about a friend who had been diagnosed with a serious and incurable but non-fatal and treatable illness.  I responded that one of the consequences would be that from now on every employment decision his friend might make would have to be based on health insurance implications.  My son said "No, Mom.  We live in Massachusetts and have Romneycare.  She is covered and cannot lose her coverage even if she changes jobs."

           As the October 1st start date of the Affordable Care Act (ACA) approaches, I attended a meeting to learn more about how it might impact my own family and all Alaskan families.  During the presentation, a woman next to me leaned over and told me that her 25 year old nephew who had purchased a high deductible insurance policy had learned six months previously that he had cancer.  He spent the entire six months trying to get any Anchorage oncologist to see him, but was consistently denied an appointment or treatment because of the type of health insurance he had.  Finally, he found a job which provided a better policy and the next day he was to begin a treatment program for his cancer.

           The significance of October 1st is that it is the first day Americans can sign up for insurance through the federal health care insurance exchanges. I’ll talk below about where to find resources for enrolling, but first I’d like to focus first on the truly revolutionary nature of the ACA and what it means for Alaskans.  Here is what I've learned.

 ACA for families

  • 43,371 non-elderly Alaskans who have a pre-existing condition can no longer can be excluded from coverage.
  • 9,000 young adults (under 26) will have health insurance. 
  • 237,000 Alaskans with private insurance no longer face   lifetime limits. 
  • 164,000 Alaskans with private insurance have preventive care, including contraception.
  • 12,344 Alaskans are receiving a rebate this year from private health insurance companies which overspent on bureaucracy.
  • 139,422 Alaskans are eligible to purchase insurance through exchange (aka “marketplace”).
  • Of those, 126,346 are eligible for tax credits to assist with purchase of health coverage or Medicaid if state accepts Medicaid funding in the future.
  • Parnell’s rejection of Medicaid excludes some 41,500 Alaskans from Medicaid coverage.

ACA for seniors

  • 60,000 Alaskans on Medicare now have preventive coverage. 
  • The Medicare trust fund’s life span has been extended by 12 years because of ACA cost savings.
  • Closing the Medicare Part D “donut hole” saves approximately $20 million per year for 2, 278 Alaskans, or roughly $788 per Medicare recipient per year (the amount of money saved per recipient will increase each year through 2020).

ACA for small businesses

  • 70%of businesses with fewer than 25 employees are eligible for tax credit assistance. 19 million Americans work in small businesses which are eligible for the tax credit.
  • Small businesses with fewer than 50 employees can participate in small business exchanges to obtain lower health insurance rates but are not required to comply with the employer mandate.
  • Insurance companies are prohibited from raising small business health insurance rates due to employees getting sick.

Healthcare Insurance Exchanges

           If you currently have health insurance, benefits for you will be felt primarily in the efficiencies that this Act imposes on hospitals and insurance companies. Healthcare insurance providers may no longer deny coverage for pre-existing conditions and or drop you from coverage if you get sick.  Specific preventative care such as flu shots and cancer screening as well as chronic care for conditions like diabetes and high cholesterol will be included in coverage.       

           If you don’t currently have insurance, and are not eligible for Medicaid or Medicare, you may apply for health insurance, with the assistance of a government subsidy through the federal health care insurance exchanges. Governor Parnell recently declined the opportunity to make the exchanges more Alaska-specific, but that doesn’t change the positive impacts the exchange will have on Alaskans. The marketplace will bring down healthcare insurance costs by pooling together the buying power of currently non-covered Americans.

           Government subsidies are available to those with incomes between 100% and 400% of the federal poverty level, or $23,050 and $92,2000, per year for a family of four, and the amount of the subsidy varies with income. The online health care insurance exchange that will open October 1, 2013 is where those currently uninsured individuals will apply. The portal will offer an easy to understand method of comparing plans, side-by-side and will cover emergency services, hospital stays, doctor visits, prescriptions and more. 

           When you’re ready to apply through the health insurance exchange, on or after October 1, you’ll head to https://www.healthcare.gov/what-is-the-marketplace-in-my-state/ to get started.

Medicaid Expansion

           Under the Affordable Care Act, states have been given the option to expand eligibility for Medicaid benefits. The expansion would extend benefits to most people under the age of 65 whose household income is at or below 133% of the federal poverty limit, or $14,865 per year for an individual and $30,657 per year for a family of four in 2012. The federal government bears 100% of the cost of this expansion through 2016 at which time their share will step down to 90% by 2020. On this topic, we can look at the Alaska Native Tribal Health Consortium’s study that charts the effects should the Governor accepts the Medicaid expansion:

1)      Basic healthcare for 40,000 currently uninsured Alaskans

2)     $1.1 billion in new federal revenue for Alaska

3)     4,000 new in-state jobs

4)     $1.2 billion increased wages and salaries paid to Alaskans

5)     $2.49 billion in increased activity throughout the state

6)     $67.3 million in savings to the state budget

           A Northern Economics study found that, by 2020, each $1 million the state of Alaska invests in the Medicaid expansion is expected to generate $28 million in additional economic activity. The Governor has not announced his decision with regards to the Medicaid expansion, but I think the benefits are clear. It’s an important time to maintain a focus on what’s best for the state and I hope the Governor keeps that in mind as he ponders his decision.

More Questions?

         The Affordable Care Act is complex, and there’s no doubt many elements might be improved.  It is, however, federal law and I hope this helps people understand a bit more about what it means for us.  

           If you interested in learning more about the Act, here are some resources I found helpful.

Understanding the Act:

A Guide to the Supreme Court’s Affordable Healthcare Act Decision. The Henry J. Kaiser Family Foundation. Focus on Health Reform. July 2012.

Key Features of the Affordable Care Act by Year. US Department of Health and Human Services. 2013.

Figuring out your best plan:

Find Your Way Around the Health Care Law. AARP.  2013 (Infographic).

What is the Marketplace in my state? US Department of Health and Human Services. 2013. (Interactive Website).

Understanding the Medicaid Expansion:

Healthier States Create a Healthier State Economy. Alaska Native Tribal Health Consortium. February 2013.

Medicaid in Alaska Under the ACA. Alaska Native Tribal Health Consortium. February 2013.

Fiscal and Economic Impacts of Medicaid Expansion in Alaska. Northern Economics. February 2013.

Conclusions:

            I hope the Affordable Care Act will help all Alaskans gain access to high-quality, affordable healthcare. Statistics show that, when compared to other countries, the US and Alaska is doing a poor job at accomplishing those goals.   I’m eager to see benefits, both in the better health and improved fiscal standing within our state.  

           I’m Berta and I’m still listening,

           If you have any questions, please feel free to contact my office

signed: Berta

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