National Health Reform -- Links to Information about the Affordable Care Act and Implementation in New York State

In March 2010, President Obama signed federal health reform into law. Health reform consists of two laws. The first and larger of the two is the Patient Protection and Affordable Care Act (PPACA) signed on March 23, 2010, and the second is the Health Care & Education Reconciliation Act, signed on March 30, 2010. Federal health reform contains many provisions which affect both public health insurance programs, such as Medicaid and Medicare, and private health insurance including the health insurance many people either get through their employer or purchase directly. The provisions of the health reform laws go into effect on a staggered basis, with some provisions going into effect immediately, but most going into effect in 2014.

Many organizations have produced extensive materials explaining and interpreting these laws and how they will be implemented.   Here are some suggested resources:

• Official U.S. website on federal health reform -- http://www.healthcare.gov/

  • The federal health reform laws  mandated that the U.S. government launch this site  -- which it did on July 1, 2010.  It will include all public and private options in all states -- users will be able to enter certain demographic and other information to identify their own local options.   By October, 2010, it will include price estimates for all insurance plans and the relative amounts each insurance company spends on medical care vs. administrative costs (called the "medical loss ratio").

  • The site also explains the new laws and timelines

  • This Fact Sheet on Immediate Benefits for New York from Health Reform was posted in 8/10, with statistics on numbers of New Yorkers affected by different provisions, such as the fact that 246,000 New Yorkers hit the doughnut hole in 2009.

  • CMS Guidance.  released the first in a series of letters providing guidance regarding the Medicaid changes and improvements that are included in the health reform laws.  The April 9, 2010 letter is available at this link:  New Option for Coverage of Individuals under Medicaid

    The letter provides initial guidance on section 2001 of the Affordable Care Act, Medicaid Coverage for the Lowest Income Populations, which establishes a new Medicaid eligibility group and the option for states to begin providing medical assistance to individuals eligible under this new group as of April 1, 2010.  For the first time since the Medicaid program was established, States will be able to receive Federal Medicaid funding to provide coverage under their State Medicaid plan for adults with income up to 133% of the federal poverty level, without regard to disability, parental status or most other categorical limitations.  Single adults and childless couples with incomes up to 100% of the federal poverty level are already eligible for public health insurance coverage in New York State under the federal waiver program, Family Health Plus.  New York faces a series of important implementation decisions going forward in order to maximize eligibility and federal contributions to the costs of coverage. 

    According the to CMS guidance, states may elect to phase-in coverage for this new eligibility group at any time, but for an effective date of April 1, 2010, states had to submit amendments to their state plans by June 30, 2010.  States will not begin to receive an enhanced match for the expansion population until January 2014.  The enhanced match established in the American Recovery and Reinvestment Act (ARRA) does not apply to these individuals.

• Official New York State website on federal health reform  -- http://www.healthcarereform.ny.gov - site created July 2010.  Includes:

  • Health Care Reform Overview
  • Health Insurance Exchanges
  • Coverage for Adult Children to Age 26 - healthreform.gov
  • The Effect on Seniors - healthreform.gov
  • The Effect on Small Businesses
  • Help for the Uninsured
  • The Effect on NYS Health Insurance Programs: Medicaid, Family Health Plus, Child Health Plus, and Medicare
  • Health Care Reform and COBRA Coverage - dol.gov
  • The Effect on New York State

  • Research and Resources -- links to text and summaries of the federal laws, and links to other helpful websites, including Kaiser Family Foundation Health Reform Website

• The NY Bridge Plan began accepting applications on August 20, 2010, with coverage available beginning October 1, 2010.  This "Pre-Exisiting Condition Insurance Plan" (PCIP) is partially funded by the federal government and subject to federal regulations established under the Patient Protection and Affordable Care Act. New York State has designated GHI to administer PCIP in New York.  This is the insurance pool for uninsured high risk individuals, who are people with pre-existing medical conditions that are expensive to treat.  

  link to a Q&A about the program, http://www.ghi.com/nybridgeplan/faq.html

  The home page is www.nybridgeplan.com.    A brochure and application can be downloaded here.  Enrollment is first come/first served.

• Advocacy Organizations:

  • Empire Justice Center -- Federal Health Care Reform: The Impact on NYS Programs

  • Kaiser Family Foundation -- http://healthreform.kff.org -- tools including an interactive timeline showing when health reform provisions take effect, all the latest polling data, short videos with Foundation experts answering specific questions about the law on a variety of health policy topics, links to other information resources, the latest headlines on health reform from Kaiser Health News, and FAQs about the new law. 

    • Health Reform Hits Main Street, a new animated short video from the Kaiser Family Foundation, features the YouToons explaining the health reform law to an American public still confused by how it works. Have you seen it? The short movie has three major sections: explaining problems in the current health care system, short-term changes that will take place between now and 2014, and major provisions that will take effect in 2014. View it online and share it with colleagues, friends and family: http://healthreform.kff.org/the-animation.aspx .  Narration by Cokie Roberts, ABC News and NPR news commentator and a member of the Foundation's Board of Trustees

  • National Health Law Program - Health Reform webpage- includes a three- part comprehensive analysis of the reform laws, including changes in private insurance, Medicaid, and other areas.

  • Center for Medicare Advocacy - has articles on changes in Medicare law, including:

    • Health Reform: the Nursing Home Provisions

    • Health Care Reform Brings State High Risk Health Insurance Pools and other articles available on homepage
      

  • Medicare Rights Center -- http://www.medicarerights.org/issues-actions/health-reform-and-medicare.php

  • National Senior Citizens Law Center -    Materials from WEBINAR: Health Care Reform & Low Income Older Adults  -- This webinar presented an overview of how the PPACA will affect older individuals, with a focus on the Medicaid long-term services and supports provisions, the provisions relating to long-term care facilities, and the changes that will have a particular impact on dual eligibles, such as certain changes to Medicare Part D and Medicare Advantage.

This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship.  To contact a lawyer, visit http://lawhelp.org/ny. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information.  To report a dead link or other website-related problem, please e-mail us.

This article was authored by the Evelyn Frank Legal Resources Program of Selfhelp Community Services, Inc.