Changes to the ACA in the New Administration

In a previous blog post, we explored the proposed replacement for the Affordable Care Act (ACA; aka Obamacare) known as the American Health Care Act (AHCA). Since then, the bill has been indefinitely tabled after it could not secure the required number of votes to pass the U.S. House of Representatives.

Prior to the new full law being proposed and pulled, the Centers for Medicare and Medicaid Services (CMS) announced changes to the Affordable Care Act exchanges. The new changes include some long-considered ideas to improve the law, including strengthening rules for those signing up for insurance outside the open-enrollment period to ensure that people are not waiting until they are sick before getting coverage.  They’ve also proposed to be more flexible for insurers in the exchanges Bronze level plans to reduce cost burdens as was proposed under Obama.

 

Other ideas put forward have deviated into some pretty striking departures from previous proposals. The new rules suggest cutting the open enrollment period in half, only running from November 1 to December 15; previously, open enrollment would run until the end of the following January. The new rules also lowers the requirements for the Silver and Gold plan levels, minimizing standards of coverage. The rule notes that the move will increase out-of-pocket costs for Americans in the short-term, but claims that it should lower premiums to offset the increase in the long-term. The new rules would allow insurers to refuse coverage until past-due premiums have been paid. They have also granted insurers more time to submit plans to the federal and state governments to plan their exchange offerings for 2018.

The nonpartisan Center for Budget and Policy Priorities (CBPP) analyzed the proposals and found that lowering standards would reduce the value of tax credits and raise the out-of-pocket costs. The CBPP illustrated a table to show how a family of four with an income of $65,000 with Silver plans could be affected, either by deductibles going up $550 per person or premiums rising $327 per year:

We at NeedyMeds will continue to provide information as the need for assistance navigating the often expensive landscape of health care rises. The NeedyMeds website has databases of Patient Assistance Programs (PAPs), Diagnosis-Based Assistance (DBAs), and Free/Low-cost/Sliding-scale Clinics to help those in need. The NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance. In addition to the plastic card, the card is available in a printable form or a smartphone app for Apple and Android devices. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

 

LGBT Health Awareness Week

The last week of March has been LGBT Health Awareness Week since 2003. We have gone over some of the barriers to healthcare for some of the transgender community in previous blog posts, but it remains important to bring awareness to the unique healthcare needs of lesbian, gay, bisexual, and transgender people and the health disparities that continue to beleaguer the lives of so many Americans.

 

rainbowcaduceusA report by the Institute of Medicine found that fear of discrimination causes many LGBT people to avoid seeking out medical care. This compromises an entire community of lesbian, gay, bisexual, and transgender individuals who are at increased risk for several health threats when compared to heterosexual or cisgender peer groups: Gay men are at higher risk of HIV and other sexually transmitted infections; lesbians are less likely to get cancer screenings; transgender individuals are among the least likely to have health insurance along with risks from hormone replacement and atypical cancers. Even as youths, LGBT people are at higher risk of violence, depression, substance abuse, homelessness, and other suicide-related behaviors.

The Affordable Care Act (ACA) has helped over 10 million Americans gain insurance. The ACA also prohibited health insurance marketplaces from discriminating on the basis of sexual orientation and gender identity. The 2015 Supreme Court ruling of Obergefell v. Hodges recognizing marriage between gay and lesbian couples throughout the United States led to more married couples to access their spouse’s health insurance, but also had the effect of cutting some domestic-partner benefits to unmarried couples offered by employers.

 

Despite steps taken, the LGBT community still ranks among the most underserved populations in terms of healthcare. Homophobia and stigma can negatively impact one’s ability to receive suitable care. Over 27% of transgender people in the US report being denied health care. Mental health is a major concern for LGBT individuals often dealing with physical or emotional abuse, body dysmorphia, depression, or feeling unsafe at school or work, and there are still areas of the United States where finding sympathetic and appropriate help can be prohibitively difficult.

For those who have experienced discrimination, the National Center for Transgender Equality has information on steps that can be taken to notify the US Department of Health and Human Services. This information is important for any member of the LGBT community who have been discriminated against in their search for healthcare. If you are looking for a LGBT-friendly medical center, the Human Rights Campaign (HRC) has an interactive map with locations of over 1500 healthcare facilities. The HRC also has information on finding insurance for transgender-related healthcare, which can be a challenge for many transgender people even after the ACA.

 

To further help those in need, NeedyMeds has a growing list of programs in our Diagnosis-Based Assistance database for transgender/gender non-conforming people that offer various forms of assistance such as financial aid or legal services. NeedyMeds’ unique crowdfunding platform HEALfundr is also available for individuals trying to raise funds for their transition and other members of the LGBT community to receive appropriate healthcare. For more information, call our toll-free helpline at 1-800-503-6897 (open 9am to 5pm ET, Monday through Friday).

American Health Care Act

After several years of attempts and Donald Trump running on platform of repealing the health care law, the U.S. Republican party has released their proposed replacement for the Affordable Care Act (ACA; aka Obamacare). The American Health Care Act (AHCA) was developed by Republicans in the House of Representatives, Senate, and the White House. The law will be debated in committees in the House and Senate before being voted on by all of Congress and then sent for the president’s signature if passed. In that time many changes could be made to the law. For now, we will outline what is being proposed to stay the same from the ACA to what may change with the AHCA.

OLYMPUS DIGITAL CAMERAThe GOP-proposed healthcare law keeps ACA provisions such as people under 26-years-old remaining on their parents’ insurance, banning insurance companies from discriminating against patients with pre-existing conditions as well as banning caps on lifetime spending. One of the more significant changes removes the tax penalty for those who don’t have insurance coverage, but instead allows insurance companies to charge 30% higher insurance premiums for an entire year for patients whose coverage lapses. The AHCA removes an Obamacare regulation that prevented insurance companies from charging their oldest enrollees more than three times as much as their youngest, putting senior Americans at particular risk with less tax credits than previous subsidies while facing premiums that may almost double. Medicaid expansion has been set with an end date of January 2020, which could drop as many as 11 million low-income Americans from their insurance coverage.

Part of the new plan is to change how tax credits are offered, basing them primarily on age instead of income. The new plan will offer the biggest tax credits to those that make less than $75,000 annually regardless of age, though these are less than the subsidies provided under the ACA. The ACA also took a person’s geographic location into account when calculating tax subsidies; the Republican plan no longer does, so people living in high-premium areas of the country (such as Alaska and Arizona) will receive the same benefit as people where insurance is cheaper (like Massachusetts and New Hampshire). In some areas of the country, American patients could receive nearly 80% less in tax credits under the new law than they did under Obamacare while contending with higher out-of-pocket costs.

 

Since its announcement, healthcare experts from across the political spectrum have come out as opposed to the AHCA, saying that it will not fix any of the problems created by Obamacare and that it would increase costs while reducing coverage. The American Association of Retired Persons (AARP) released a statement opposing the proposals for putting senior Americans at risk of not being able to afford coverage. The American Medical Association (AMA) also sent a letter to the House committees that wrote the bill, outlining their concerns they would write a bill that “would result in millions of Americans losing coverage and benefits.”

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The American Health Care Act has also received bipartisan criticism in Congress. Other than Democrat resistance, a number of Republican Congressmen have been skeptical that a replacement is enough of a repeal of the ACA. Furthermore, Senate Majority Leader Mitch McConnell (R-KY) has stressed the importance of the Congressional Budget Office’s (CBO) estimates on how the bill will affect the federal deficit and the number of insured Americans; the House of Representatives has rushed the AHCA through numerous committees before the CBO’s report release Monday.

The CBO report projects up to 14 million Americans losing their insurance in 2018—more than the number of people who got insurance under the ACA. Within 10 years, an estimated 24 million otherwise insured Americans would be without coverage. The report found that premium costs would rise 15-20% by 2018 before beginning to normalize by 2020. By 2026, premiums may be 10% less than they would be today—excluding senior Americans, who insurers would be allowed to charge five times more than younger enrollees.

 

There will be developments in the American Health Care Act and any repeal or changes to the Affordable Care Act, and we at NeedyMeds will try to keep up-to-date on the details. We at NeedyMeds prefer to remain apolitical—we work in a diverse office with people of varying backgrounds and views—but we believe in being informed and that those in need deserve care. It should be clear that NeedyMeds supports improved access to care as well as lower costs for medications and healthcare services for all.

 

The NeedyMeds website has databases of Patient Assistance Programs (PAPs), Diagnosis-Based Assistance (DBAs), and Free/Low-cost/Sliding-scale Clinics to help those in need. The NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance. In addition to the plastic card, the card is available in a printable form or a smartphone app for Apple and Android devices. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

International Women’s Day

Today is International Women’s Day. International Women’s Day started in 1908 when 15,000 women marched through New York City to demand shorter hours, better pay, and voting rights after being oppressed and mistreated in the workplace since the industrial revolution. The movement spread across the globe in the following years, reaching Europe by 1910 and Russia by 1913. International Women’s Day was officially recognized by the United Nations in 1975.

The women of NeedyMeds

The women of NeedyMeds

Women’s health is an important part of International Women’s Day. Women remain an underserved community with unique healthcare costs that are often overlooked by those drafting insurance guidelines. In a previous blog post, we explored how Planned Parenthood has provided low-income men and women with affordable care including cancer and STI screening, pre-natal care, and help finding further assistance through grants or government programs. Since then, funding cuts and new state laws forcing Planned Parenthood clinics to close has dropped the number of people screened for cancer by nearly 250,000.

A newly proposed replacement for the Affordable Care Act (ACA; aka Obamacare) includes cutting off federal funding to Planned Parenthood because they also provide abortions, despite the fact that abortions make up only 3% of Planned Parenthood’s services and zero federal funds go towards paying for abortions. Federal funds make up 60% of Planned Parenthood’s budget, of which most comes as reimbursement from Medicaid for routine coverage such as cancer/STI screenings and maternity healthcare. It is estimated that these cuts would cause 390,000 women to lose access to affordable care and up to 650,000 could have reduced preventative care within a year. The new healthcare law also plans to cut funding from any private insurance company that offers abortions, which would force women to pay out-of-pocket for a procedure that can cost upwards of $500-$1000. We’ll have more on the new healthcare law being proposed next week.

NeedyMeds has many resources for women’s health. In a previous blog, we outlined the National Breast Cancer and Cervical Cancer Early Detection Program (NBCCEDP), that provides cancer screening for uninsured or underinsured women who earn less than 250% of the Federal Poverty Level. The program also provides assistance for women who are diagnosed with cancer through the program. Each state has their own program that can be found through NeedyMeds’ State-Sponsored Programs database.

NeedyMeds has a database of nearly 15,000 free, low cost, or sliding scale clinics, over 4000 of which offer women’s health services, including 500 Planned Parenthood locations. Search your ZIP code for clinics in your area, and find Women’s Health in Services under the Details heading to find free or low-cost medical attention.  Assistance for women’s health can also be found in our Diagnosis-Based Assistance database by searching for conditions that affect the women in our lives.

For those unable to afford their prescriptions, NeedyMeds has an extensive database of Patient Assistance Programs (PAPs). NeedyMeds also has information on Coupons and Rebates that can help lower the cost of necessary medications. For those without any prescription coverage, the NeedyMeds Drug Discount Card saves 0-80% on any prescribed medication. A plastic card can be ordered online or requested through our toll-free helpline, or a printable version can be found on our website as well as a smartphone app on Apple and Android devices.

For more resources check our website at Needymeds.org or call our toll-free helpline at 1-800-503-6897, open Monday through Friday 9am to 5pm Eastern Time.

National Eating Disorder Awareness Week

This week is National Eating Disorders Awareness Week in the United States. Eating disorders are serious mental health issues that can lead to serious and potentially life-threatening complications. Despite being commonly associated with women, men can also develop eating disorders; studies suggest 1 in 20 people—30 million Americans—are affected by an eating disorder at some point in their lives.

There are three different conditions that we qualify as eating disorders:

  • anoressiaAnorexia Nervosa is when a person denies themselves food to the point of self-starvation in the obsessive pursuit of weight loss. People with anorexia will deny hunger and refuse to eat, and may practice binge eating and purging or exercise to the point of exhaustion. Emotional symptoms include irritability, social withdrawal, lack of emotion, fear of eating in public, and obsessions with food and exercise. Food rituals are often developed, or whole categories of food will be eliminated from the person’s diet out of fear of getting “fat”. Low food intake and inadequate nutrition causes the patient to become very thin, forcing the body to slow down to conserve energy causing many symptoms: irregularities or loss of menstruation, constipation, abdominal pain, irregular heart rhythms, low blood pressure, dehydration, and insomnia.

  • Bulimia Nervosa is typically characterized with binge eating followed by purging through forced vomiting, abusing laxatives, or excessive exercise. The person will feel out of control when eating large amounts over short periods of time followed by desperately trying to rid themselves of extra calories. People with bulimia may appear physically healthier than someone with anorexia but often suffer from low self-esteem overly linked with body image, feeling out of control, guilty, or shameful about eating and withdrawal from friends and family. Binging and purging can severely harm teeth and stomach tissues. Excessive purging can lead to dehydration that affect the body’s electrolytes and leads to cardiac arrhythmias, heart failure, and can be fatal.

  • Binge Eating Disorder (BED) is when a person eats a very large amount of food in a short period of time, possibly when they weren’t hungry or even uncomfortably full. People with BED often feel embarrassed, disgusted, depressed, or guilty about their behavior. Binge Eating Disorder does not include purging as someone with anorexia or bulimia might. People with binge eating disorder may range anywhere from normal weight to obese.

 

Eating disorders are complex conditions that are still being learned about. Many people who suffer from them have underlying mental illness or are otherwise coping with overwhelming feelings and painful emotions. Unfortunately, the methods of coping with eating disorders only damage the person’s physical and emotional health more, furthering lowering self-esteem and sense of control.

People with siblings or parents with an eating disorder have shown to be at higher risk of developing an eating disorder themselves. Cultural pressures found in popular culture, peer pressure among young people, and overall emotional health can all contribute to the development of these dangerous behaviors. Times of change in one’s life such as going to college, starting a new job, or getting divorced can be a stressor towards developing an eating disorder. Eating disorders are especially common among certain athletes such as gymnasts, runners, wrestlers, and dancers.

 

Diagnosing an eating disorder can be difficult, especially if the person suffering is resistant to help. If an eating disorder is suspected, a doctor will usually perform a physical exam, conduct an interview and order lab tests along with a mental health professional’s evaluation. In cases where eating disorders are a sign of a larger mental health condition, identifying and addressing them with comprehensive treatment helps ensure a lasting recovery. Treatments for mental health disorders can vary widely, though psychotherapy and medicine are often prescribed as well as crucial nutritional counseling and weight monitoring.

National Eating Disorder Awareness Week 2017’s theme is It’s Time to Talk About It. Eating disorders are a serious public health concern and staying silent only continues the stigma and pain of those suffering. The National Eating Disorder Association (NEDA) has a free and confidential screening for eating disorders available online. NEDA also has a toll-free helpline, crisis support via text messaging, and online chat. They even have resources for loved ones trying to navigate the challenging process of helping someone living with an eating disorder.

 

In a previous blog post, we outlined the resources available for major depression which can be a contributing factor to eating disorders. We also have information for over 3000 free, low-cost, or sliding-scale clinics throughout the country that offer counseling or mental health services. Search your zip code for clinics that may offer Counseling/Mental Health Services near you, or call our toll-free helpline at 1-800-503-6897 (Monday-Friday, 9am-5pm ET) for information.

 

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