California

October 15, 2018 – January 15, 2019

Colorado

November 1, 2018 – January 15, 2019

Connecticut

November 1, 2018 – December 15, 2018 (not extended)

District of Columbia

November 1, 2018 – January 31, 2019

Idaho

November 1, 2018 – December 15, 2018 (not extended)

Maryland

November 1, 2018 – December 15, 2018 (not extended)

Massachusetts

November 1, 2018 – January 23, 2019

Minnesota

November 1, 2018 – January 13, 2019

New York

November 1, 2018 – January 31, 2019

Rhode Island

November 1, 2018 – December 31, 2018

Vermont

November 1, 2018 – December 15, 2018 (not extended)

Washington

November 1, 2018 – December 15, 2018 (not extended)

In this special Health Reform: Beyond the Basics webinar presented on September 18, 2018, Karl Cooper, Director of Public Health Programs at the American Association on Health and Disability (AAHD), addresses disability etiquette and basic accessibility considerations for anyone doing enrollment work, as well as provides an overview of questions a person with a disability needs to think about when considering their health care options in the marketplace. In addition, he provides an overview of the resources available through the National Disability Navigator Resource Collaborative (NDNRC).

Presentation Slides

↓ View presentation slides (PDF) 

Watch the Webinar

Overview of What’s Covered

Overview of AAHD

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• AAHD mission
• Health disparities for people with disabilities

Disability Etiquette

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• People with all types of disabilities
• People with mobility disabilities
• People who are blind or low vision
• People who are deaf or hard of hearing
• People with speech and language disorders
• People with cognitive or intellectual disabilities
• People with mental health or behavioral health disabilities
• Disability accessibility and accommodations

National Disability Navigator Resource Collaborative (NDNRC)

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• Overview of the Affordable Care Act’s impact on people with disabilities
• Overview of NDNRC and enrollment resources
• Resource: Guide to Disability for Health Insurance Navigators
• Resource: Topical and population-specific fact sheets
• Needs by disability category
• Resource: Community Outreach Collaboratives

Considerations When Assessing Health Plan Options

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Health Insurance Jeopardy: It’s not about the answer. It’s about asking the right question!

• Topical questions
• Population specific questions
• Accessibility and disability etiquette
• Resource: Health Insurance Jeopardy Series | View NDNRC YouTube channel

Ongoing Challenges

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• Limited provider networks
• Limited formularies
• Discriminatory pharmacy design
• Plan transparency
• High out-of-pocket costs
• Confusion on the definition of “rehabilitation” and “habilitation” services and supports
• Confusion on the coverage of prosthetic devices and durable medical equipment
• Confusion about coordinating exchange coverage with Medicare and Medicaid
• Delays in getting plan information once they are enrolled
• Communication issues for deaf and hard of hearing

Additional Resources

Resources | View resources links

American Association on Health and Disability (AAHD) | Find out more

AAHD | National Disability Navigator Resource Collaborative (NDNRC)

• Guide to Disability for Health Insurance Navigators
• Topical and population-specific fact sheets
• Community Outreach Collaboratives

AAHD | NDNRC: Health Insurance Jeopardy Series | NDNRC YouTube channel

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts

Tools and Resources | View all tools and resources

Frequently Asked Questions | View FAQs

↓ Read the final rule

↓ Read the guidance on hardship exemptions 

For an overview of the rule changes, see our paper, “Health Care Rule Changes Will Harm Consumers,” detailing how these changes will weaken benefit standards, likely harming people with pre-existing conditions; raising new barriers for people who want to enroll in health coverage; and reducing accountability for insurers and transparency for consumers.

Changes from the final rule and additional guidance include:

Altered rules for navigator programs.  Under the rule, marketplaces are permitted to have just one navigator entity serve the entire state. In addition, the rule allows navigators to not have a physical presence in the state they are paid to serve and no longer requires that one navigator group in a service area be a consumer-focused nonprofit organization.

New requirements for verification of income.  The rule requires individuals to verify their income if their attested income is above the poverty line but data sources suggest that income is below the poverty line. This will make it harder for eligible individuals with fluctuating poverty-level income to access much-needed financial help to afford coverage.

Expanded hardship exemption.  Effective immediately, new guidance expands the situations in which people can receive a hardship exemption to include people who:

• Show that a lack of choice when there is only one issuer in their area “precluded” them from obtaining coverage;
• Cannot buy an affordable plan that does not include abortion coverage, which is contrary to the individual’s beliefs;
• Have no qualified health plan in their area (a circumstance no marketplaces have ever experienced); or
• Experience personal circumstances that may qualify as a hardship, such as when available QHPs don’t cover needed specialty care.

New special enrollment period (SEP) for loss of pregnancy-related coverage provided through CHIP.  The rule adds an additional SEP for the loss of coverage provided through the Children’s Health Insurance Program (CHIP) “unborn child” option, which only covers pregnancy-related services and is not considered minimum essential coverage. This SEP will go into effect on June 18, 2018.

Removes requirement to provide adequate notice to those who fail to reconcile APTC.  People who receive APTC are required to file a tax return and reconcile the tax credit, or they risk losing financial assistance when they re-enroll. Current rules require that the Marketplace must first provide enrollees with information about failure to reconcile, giving them a chance to correct the record if they in fact reconciled or remedy the situation by filing a tax return, but the new rule removes that requirement to first send notice directly to the tax filer before discontinuing APTC.

Allows states and insurers to scale back benefits.  Beginning in 2020, the new rule changes the standards for how states create a benchmark plan to establish the minimum standard for the ten essential health benefits offered in that state and how insurers comply with them, opening up new ways for states and insurers to scale back coverage of services that are costly but critical to people with serious health needs.

There are additional changes in the rule including weakening the risk adjustment program by letting states shrink risk adjustment transfers by up to 50%, reduced transparency of insurance premium rates, and diminished standards for the “medical-loss ratio” requiring insurers to spend at least 80% of what they collect in premiums on medical care and improving healthcare quality. For more detailed information on the harmful changes in this rule, please see our paper, “Health Care Rule Changes Will Harm Consumers.”

Developed as part of the Consumer Assistance Coordination Hub (CACH), the National Association of Health Access Assisters developed a resource for assisters: Incorporating Volunteers into Outreach and Enrollment Work.

This resource outlines how enrollment assister organizations can utilize volunteers to help spread the word and ensure people enroll in coverage to make the most of this open enrollment period.

↓ View Incorporating Volunteers into Outreach and Enrollment Work

Developed as part of the Consumer Assistance Coordination Hub (CACH), the National Immigration Law Center developed a resource for assisters: Tips for Addressing Immigrant Families’ Concerns When Applying for Health Coverage Programs.

This resource includes suggestions on how to address concerns when talking to families, information on protections for household members not applying for coverage, and lists additional resources.

↓ View Tips for Addressing Immigrant Families’ Concerns When Applying for Health Coverage Programs