Health Care Reform
In 2010, Congress passed and President Obama signed the Patient Protection and Affordable Care Act. CDA was pleased to see pediatric dental benefits included as one of the Act’s Essential Health Benefits that will be offered.
While the Exchange has not yet released the number of pediatric dental benefit policies sold in its first open enrollment period, the agency continues to move forward with its plans for 2015. Medical plans as well as dental plans have submitted bids to the Exchange to participate and sell policies in 2015. Those bids are sealed, so we have little detailed information on them – including any dental plans that have asked to join the Exchange – but we know that the Exchange staff is actively negotiating with plans on the premium rates being offered by those hoping to sell products in the Exchange.
The ballot measure that would quadruple the cap on non-economic damages under the Medical Injury Compensation Reform Act (MICRA) has been assigned a number, Proposition 46, for the upcoming November election, while the campaign against it is gaining more powerful allies. CDA and an expanding coalition of health care organizations and others are working to defeat Prop. 46 because it would have devastating effects on California’s health care system, increasing costs by billions of dollars annually.
Interest remains high in the provisions of the federal Affordable Care Act (ACA) health reform law, as indicated by the attendance at a CDA Presents The Art and Science of Dentistry lecture in Anaheim on the ACA. CDA Legislative Affairs Manager Nicette Short presented “National Health Care Reform: How Will It Affect Your Practice?” — a course designed to provide information about the Affordable Care Act, its scope of coverage to individuals and small businesses and its potential impact on dentists, the oral health care delivery system and the dental benefits market.
CDA-sponsored legislation to require dental plans to adhere to the same administrative cost limitations as medical plans took a major step forward April 8. AB 1962 passed the Assembly Health Committee on a 15-3 vote over strong opposition from the dental plan industry. AB 1962 would remove the dental plan exemption from state law that requires health plans to allocate a minimum of 80 percent of their premium revenue to actual patient care.
As of March 31, the first open enrollment period in health care reform implementation through the California Health Benefit Exchange’s individual market (Covered California) is in the books. So, it is now time to start thinking about what happens next for the people who have new dental policies and what treating these patient will mean for dentists. If and when a patient comes into your office with Covered California dental coverage, it is important to remember that what they really have is private dental insurance.
Even with the rollout of the Affordable Care Act (ACA) barely under way, Covered California, the agency charged with implementing the ACA in this state, devoted considerable time last month to planning for expanded dental benefit offerings for 2015. CDA has continued to push for making a variety of plan options available to all consumers, including adults, and the state is now moving in that direction, with many details still to be worked out.
There is still much uncertainty regarding the overall and long-term impacts of the Affordable Care Act (ACA) on the health and dental care delivery systems. What we do know, however, is that the ACA will usher in access to dental care for many more children outside of the ACA-created online insurance marketplaces – including coverage through most private health insurance plans.
As of Jan. 1, 2014, many of the major reforms created by the Affordable Care Act (ACA) are in place. While the law is lengthy and has many complicated provisions, there are four basic concepts implemented by the law: providing private and public health insurance reforms and patient protections; allowing states to expand Medicaid coverage; requiring U.S. citizens to have health insurance coverage or pay a penalty; and creating marketplaces for health and pediatric dental insurance coverage.
CDA is working with Covered California staff to identify additional training that needs to be provided to the enrollment specialists to help them better support families in accessing the dental benefits that are available to them. In addition, CDA is providing feedback to Covered California on the short-term, and perhaps longer-term, fixes that need to be made to the website to ensure that families who want to buy the dental coverage through the portal can do so efficiently.
After a rocky first few days following its long-anticipated Oct. 1 opening for enrollment, Covered California, the state health insurance marketplace created by the Affordable Care Act (ACA), has now reported some data on the number of consumers who have been able to access health insurance through the new marketplace. CDA remains actively engaged in all of the ACA’s implementation details and can be a resource to members interested in finding out more about the new law and how it may impact dentists and dentistry.
After months of intense preparation, Covered California, the health insurance marketplace created by the Affordable Care Act (ACA), began its open enrollment period on Oct. 1. Consumers can now begin the process of comparing and purchasing affordable medical and dental insurance coverage online, and Covered California is offering in-person and phone support for those who need it.
The ADA has announced the release of the first set of dental performance measures under the Dental Quality Alliance (DQA). The DQA, comprised of multiple stakeholders from across the oral health community, was created to establish a series of oral health care performance measures.
The Affordable Care Act (ACA) amended the federal Fair Labor Standards Act, creating a requirement that employers provide a notice to all employees of the existence of the newly formed insurance marketplace available to them along with information on how to contact the insurance marketplace to request assistance in purchasing coverage if the employee chooses to do so.
California’s Health Benefit Exchange Board, which is tasked with implementing the federal Affordable Care Act in California, held a special meeting on Aug. 8 to focus primarily on issues surrounding the implementation of the pediatric dental Essential Health Benefit. The board upheld its decision to allow only stand-alone dental plans and ruled that it was too close to the date of open enrollment (Oct. 1, 2013) to allow traditional health plans to submit new bids including the pediatric dental benefit at this time. CDA strongly supported the Exchange’s decision to allow stand-alone dental plans.
Covered California, the health and dental insurance online marketplace created by the Affordable Care Act (ACA), has announced the dental plans that will be available for purchase through the Exchange. Six plans were chosen: Anthem Dental; Blue Shield of California; Delta Dental of California; Health Net Dental; LIBERTY Dental Plan; and Premier Access Dental.
Legislation aimed at making sure dental plans put more of their revenues into actual care for patients passed its first legislative hurdle. AB 18 (Pan), championed by CDA, successfully moved through the Assembly Health Committee, overcoming strong objections from dental plans and health plans.
Legislation aimed at making sure dental plans put more of their revenues into actual care for patients passed its first legislative hurdle. AB 18, authored by Assemblyman Dr. Richard Pan (D-Sacramento) and sponsored by CDA, overcame strong objections from dental plans and health plans.
CDA is sponsoring legislation to apply key patient protections and market reforms, including a minimum loss ratio on patient premiums, to dental plans participating in California’s new health plan marketplace, the Covered California health benefit exchange. The Affordable Care Act (ACA) includes many consumer-focused provisions that have already gone into effect, but that only apply to medical plans. Assemblymember Dr. Richard Pan (D-Sacramento), who chairs the Assembly Health Committee, has introduced AB 18, sponsored by CDA, that if passed by the legislature and signed by the Governor, would represent the first time these federal patient protections would be applied to dental plans participating in the small group market inside and outside the new health benefit exchange created by ACA.
If attendance is any indication at a CDA Presents lecture on national health care reform, dentists are eager to learn more about the issue and its impact on their practices as well as employee and personal health coverage. CDA Legislative Affairs Manager Nicette Short presented “National Health Care Reform: How Will It Affect Your Practice?” — a course designed to provide information about the Affordable Care Act and its potential impact on dentists, the oral health care delivery system and the dental benefits market — last month at CDA Presents in Anaheim.
All TDIC Insurance Solutions plans, including Anthem, Kaiser and others, will be impacted by the Affordable Care Act at levels that are yet to be determined. As we move into 2014, plans continue to cite ongoing increases in the cost of providing health care as reasons for recent actions to raise premiums – even before full implementation of ACA. Because of this, TDIC Insurance Solutions is diligently working with experts in the industry to both determine the possible effects and explore alternatives for its health care policyholders.
It has been three years since the passage of the Patient Protection and Affordable Care Act (ACA), and full implementation of the federal health care reform law is now less than eight months away. From nearly the moment of its passage at the federal level, California has been leading other states in working toward its Jan. 1, 2014, implementation, despite the fact that federal regulations providing guidance to states on key implementation details have not all been finalized.
The U.S. Department of Health and Human Services (HHS) recently issued final rules regarding the implementation of the Affordable Care Act (ACA) that included much needed clarification on federal policy related to access to dental care inside and outside of the Health Benefit Exchanges — the health and dental insurance marketplaces created by the ACA.
CDA is pushing for patients to have a flexible range of coverage options and the ability to choose their dentist, a model that reflects the way dental care historically has been provided.
An annual health care spending report by the Centers for Medicare & Medicaid Services suggests the dental economy is growing; however, the amount spent by consumers remains flat, according to an ADA analysis.
California continues to move toward the Jan. 1, 2014, implementation of national health care reform, and CDA has been working closely with policymakers on issues important to dentistry.
The January 2013 issue of the CDA Update features a recap of the latest Dental Benefits Research Task Force meeting, which included presentations from group practice and network management experts. It also includes a look ahead at CDA Presents The Art and Science of Dentistry in Anaheim. Featured is a panel discussion that can help attendees increase their decision-making skills in terms of technique, materials and procedures.
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