POLICY UPDATE: The American Health Care Act (AHCA)–click to read the bill.
On March 6, 2017, House Republicans introduced the American Health Care Act (AHCA). The AHCA aims to repeal parts of the Affordable Care Act through a process called budget reconciliation (meaning the bill can only address budget-related provisions).
The bill maintains key patient protections including the ban on denying coverage for individuals with preexisting conditions, the ban on lifetime and annual caps on benefits, allowing children to stay on their parents insurance until age 26, and the limit on out-of-pocket maximums.
However, the ACHA would freeze enrollment in the Medicaid expansion in 2020 and change Medicaid funding to a 'per capita cap,' enact a 30% surcharge on premiums for individuals who do not maintain continuous health insurance coverage, and eliminate ACA subsidies to buy insurance.
What do we do?
HFM has a long history of involvement in legislative policy issues and advocacy outreach. Lansing Day, our state advocacy day, has become a permanent fixture of our organization since its inception in 2005. Our legislative day allows constituents the opportunity to visit with legislators and educate them on the needs and special interests of the bleeding disorders community. Lansing Day is held every May, join us this year for Lansing Day 2017, May 23rd and 24th.
We are happy to share that HFM has created an advocacy committee to assist staff members enhance our advocacy program and develop a year-round structure of involvement. Our advocacy committee includes community members, NHF/HFA representatives, government relations specialists, and other external stakeholders and meets once a month.
HFM attends national advocacy events, including the National Hemophilia Foundation's annual legislative day, Washington Days.
Our advocacy staff monitors and researches policy issues that may negatively impact members of the bleeding disorders community.
What is going on?
What we are paying attention to…
On the state level, HFM is monitoring the following issues:
- Michigan’s Children’s Special Health Care Services program.
- The Medicaid carve-out for clotting factor.
- Adequate Medicaid pharmacy reimbursement for bleeding disorder therapies.
- Step therapy or “fail first” cost control practices.
- Prior authorization process.
- Access to dental care for people with bleeding disorders.
What is Children's Special Health Care Services (CSHCS)? And why is it so important for the Michigan bleeding disorders community?
Children’s Special Health Care Services is a program within the Michigan Department of Health and Human Services, provided under Title V of the Federal Social Security Act. It is designed for children and some adults with specialty health care needs.
CSHCS covers people until the age of 21 with a qualifying medical condition. However, the age limitation is waived for patients with certain blood clotting disorders (Hemophilia and other bleeding disorders) and cystic fibrosis.
CSHCS helps cover the costs associated with treatment for bleeding disorders. These services can include paying specialty medical bills, coordinating services from multiple providers, education about specialty providers, coordinating health insurance benefits, and covering copays/deductibles.
On the federal level, HFM works with the National Hemophilia Foundation and the Hemophilia Federation of America to stay aware of any changes that may impact our community. HFM is in constant communication with NHF and HFA policy staff members and represents Michigan at NHF's federal legislative advocacy day, Washington Days.
ACA, Medicaid Expansion
In the current political climate, changes to health care have been front and center for people with chronic conditions. While it is not clear of the exact changes that policy makers might make to the current healthcare system, it is imperative that the bleeding disorders community stay alert and informed.
To read details on health care changes, including congressional actions regarding the Affordable Care Act and Medicaid/Medicare, throughout the transition visit HFA's Health Legislation Outlook.
To find out how Michigan is impacted by the ACA’s Medicaid Expansions, click here.
ACA rules and regulations that have a positive impact on the bleeding disorders community:
- Coverage for individuals with pre-existing conditions
- No annual or lifetime limits on benefits
- Children can receive coverage under their parent's health plan until the age of 26
- Caps on out-of-pocket expenses
What can you do?
- Take HFM’s Access to Treatment Survey to help HFM stay updated on the access to care issues affecting our community.
- NEW this year, HFM is working to coordinate Coffee with Your Legislator events in 2017. Stay tuned for more information!
- Contact your representatives and let your voice be heard.
- Attend HFM’s annual state legislative day, Lansing Day.
- Do you have a specific insurance issue? Contact HFA's Project CALLS below:
Questions or comments?
Contact Sarah Procario at firstname.lastname@example.org or 734.961.3516
Support HFM with your tax-deductible donation.
Sign up for your annual membership to the Hemophilia Foundation of Michigan!
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