Human Arc Blog

  • Legal Challenges to Federal Insurance Marketplace Subsidies

    Shanna Hanson - October 15, 2014

    The Affordable Care Act (ACA) provides tax credits and subsidies to purchase Qualified Health Plans on state-run insurance exchanges. A May 23, 2012, Internal Revenue Service (IRS) rule extended the tax credits and subsidies to consumers buying health insurance through federal exchanges in states without their own exchanges. Some lawsuits are challenging the legality of [...]

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  • Affordable Care Act Increases Emergency Department Demand

    Human Arc - October 3, 2014

    Emergency Department Demand Up Emergency department (ED) visits are on the rise, according to recent studies that examine the impact of the Affordable Care Act (ACA) on EDs. A new study by the Colorado Hospital Association (CHA) of over 450 hospitals in 13 Medicaid expansion states and 12 non-expansion states shows how the Affordable Care [...]

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  • Same-Sex Marriage and Health Care Coverage

    Shanna Hanson - September 18, 2014

    In 2013, the U.S. Supreme Court ruled as unconstitutional section 3 of the Defense of Marriage Act, defining marriage based on gender. Since then, a series of guidance and policies have been published that impact health care assistance eligibility for individuals in same-sex marriages. Four notable ones are described below. Internal Revenue Ruling 2013-17 was [...]

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  • New Special Enrollment Periods for “Limited Circumstances”

    Shanna Hanson - September 4, 2014

    The first open enrollment period to obtain health insurance through a Qualified Health Plan (QHP) ended March 31, 2014. Some life changes create an enrollment opportunity outside open enrollment. In an earlier post, I shared information about this and also about a limited special enrollment period (SEP) for high-risk pool participants and COBRA beneficiaries.  Now [...]

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  • Social and Economic Wellness can improve Patients’ Health

    Shanna Hanson - August 21, 2014

    In the changing era of value-based purchasing, readmission penalties and Accountable Care Organizations (ACOs), it’s increasingly important for providers to focus on socioeconomic wellness factors in addition to clinical care. But why? Clinical care accounts for only 20% of health status and outcomes. Another 40% is attributable to social and economic factors including but not [...]

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  • ICD-10: Preparing for Implementation in 2015

    Human Arc - August 14, 2014

    The Department of Health and Human Services issued a final rule in July formalizing Oct. 1, 2015, as the compliance deadline for conversion to ICD-10 diagnostic and procedure codes.   This final rule is important because it accelerates the rule-making process, bypassing the formal comment period otherwise available to discuss the date, according to this Modern [...]

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  • Presumptive Eligibility: Opportunities and Challenges

    Shanna Hanson - July 30, 2014

    The Affordable Care Act (ACA) requires all states to allow Qualified Hospitals (QHs) to make presumptive eligibility (PE) Medicaid determinations for individuals meeting financial and non-financial eligibility criteria based on self-attestation. Additionally, the ACA gives states the discretion to allow other Qualified Entities (QEs) to make PE decisions. While PE presents the opportunity to make immediate [...]

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  • Patients Will Need Help with Insurance Renewals

    Human Arc - July 17, 2014

    “Enrolling more than 12.8 million Americans in Marketplace coverage [Qualified Health Plans or QHPs], Medicaid, or CHIP during the initial open enrollment period was a monumental achievement, but the true measure of success will be ensuring those gains in coverage are maintained over the long term …” states State of Enrollment: Lesson Learned from Connecting [...]

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  • Looking Ahead to Open Enrollment

    Shanna Hanson - July 8, 2014

    “I didn’t think I could afford insurance so I never applied.” …“I didn’t know financial help to pay for insurance was available to me.” … “I didn’t know I could sign up for coverage.” There is a common theme to these reasons for remaining uninsured: lack of knowledge and understanding. In a survey commissioned by [...]

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  • Coverage Options for Pregnant Women under the ACA

    Shanna Hanson - June 24, 2014

    Under the Affordable Care Act (ACA), pregnant women can get caught in a revolving door between Medicaid or Children’s Health Insurance Program (CHIP) coverage and Qualified Health Plans with premium assistance and cost sharing benefits. Some states are confused by the regulations and may offer inaccurate information. This is partially the result of overlapping eligibility [...]

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