Day 3: Building Momentum

We have learned that health is not an individual issue. What we are most recently learning (sometimes the hard way) is that health is not just an issue for the medical world, the government, and those interested in public health. Health is an issue that everyone has to be concerned about and this includes entities within the government, non-profit and community settings, and even the for profit world. Below are some great momentous activities that have been going on.

I’m particualry excited about the decision of cvs to stop selling tobacco products. That was a huge step for them to take and a huge risk since tobaccos sales are a big part of these pharmacy and wellness stores. It makes sense that a store focused on health and wellness would stop selling products that are the exact opposite of health and well-being. I think that there are other things that they could be looking at as well, but this was a huge step and I hope the Walgreens, Rite Aids and other stores of the world will catch up as well.

Debates around the Affordable Care Act have brought added attention to prevention and public health. As a result, we’re beginning to see a broad range of influential organizations taking important steps in line with creating the Healthiest Nation. Yet, as we celebrate the gains we’ve made, a key challenge will be to expand and build upon this momentum.

Facts & Stats:

  • At APHA, we’ve developed a strategic plan for the public health community to help America become the Healthiest Nation in One Generation!
  • Robert Wood Johnson is re-positioning the foundation’s work behind the goal of “creating a culture of health.”
  • In 2014, the American Planning Association – the organization of professionals who help communities plan for growth and change – for the first time dedicated a full day of their annual meeting to health.
  • The First Lady Michelle Obama’s Let’s Move! initiative is gaining traction in addressing childhood obesity & raising a healthier generation of kids.
  • Even in the for-profit sector we see companies seeking a better balance between their profits and the health of their customers:
    • CVS Health has stopped selling tobacco products and has expanded their programs to help people quit.
    • Sixteen major food and beverage companies reduced the calories in the products they sold by 6.4 trillion calories.

What’s next? Together we can create the healthiest nation in one generation.

We have a lot of challenges to overcome, but it all starts with a simple first step:

Sign the pledge to show your commitment.  Ask others to sign as well because the more people who sign, the more influence we have to drive change.

Sign the petition to ask our leaders to do their part.  It will take change at both the local and national level to ensure our communities make a positive impact on our health.

Day 2: Starting from Zip

So I got a little behind in posting each day this week, but this is still very important information. There is a lot of work going on in the U.S. in terms of life expectancy and zip codes. I would love to do some of this research in Michigan and specifically with the metro area. Although knowing this data doesn’t automatically solve problems, its a great place to start awareness and create the buy-in that is necessary to make changes on a large scale.

If you take a lot at the links below you can see that Wayne County has over 9,000 years of potential life lost before 75 in 100,000 people. Compare this to just over 5,000 in Washtenaw County.

Facts & Stats:

  • In the area served by the Washington, D.C. metro system, communities only 12 miles from each other can have a nine year difference in life expectancy! (Source: RWJ Commission to Build a Healthier America graphic via APHA website)
  • In the U.S. there is a 13% difference (9 years) in life expectancy between states.
  • Use these great resources to find specific data for how your county and state rank!

What’s next? Together we can create the healthiest nation in one generation.

We have a lot of challenges to overcome, but it all starts with a simple first step:

Sign the pledge to show your commitment.  Ask others to sign as well because the more people who sign, the more influence we have to drive change.

Sign the petition to ask our leaders to do their part.  It will take change at both the l

National Public Health Week- Raising the Grade

National Public Health Week- Raising the Grade

Today is the first day of National Public Health Week (#NPHW). I will be sharing posts and information regarding the daily themes.

Today’s theme is raising the grade. It’s sad to think that the U.S. is so far behind the curve in terms of health care yet we have the highest medical expenditures (17.9 of the Gross Domestic Product expenditures). In this case high spending does not equal quality.

Below is some information from the American Public Health Association regarding our current status.

What does the data reveal about America’s health?

The U.S. doesn’t have the top health care system – we have a great “sick care” system. We have great doctors, state-of-the-art hospitals and we’re leaders in advanced procedures and pharmaceuticals. But studies consistently show that despite spending twice as much, we trail other countries in life expectancy and almost all other measures of good health. This holds true across all ages and income levels. So what is missing?  We need a stronger public health system that supports healthy communities and moves us toward preventing illness, disease and injury.

Facts & Stats:

We’ve seen some improvements!

In 2013:

  • Smoking continued its decline from 19.6% to 19.0% of the adult population.
  • Immunization coverage increased from 64% to 67.1% of adolescents aged 13 to 17 years.
  • We have many successes like increasing life expectancy, reducing infant mortality and declining cardiovascular deaths – but other countries are succeeding faster than we are.

And yet, compared to peers in other countries, people in the U. S. have…

  • Shorter lives – Over the past 25 years U.S. life expectancy has grown, but at a slower rate than in other countries. Studies consistently show we have a lower life expectancy than comparable countries.
  • Adverse birth outcomes – we have the highest infant mortality rate, low birth weights, the highest rate of women dying due to complications of pregnancy and childbirth and children are less likely to live to age 5.
  • Highest rates of injury and homicides – deaths from motor vehicle crashes, non-transportation injuries and violence occur at much higher rates than in other countries.
  • Heart disease – the U.S. death rate from ischemic heart disease is the second highest; at age 50 Americans have a less favorable cardiovascular risk profile and adults over age 50 are more likely to develop and die from cardiovascular disease
  • Obesity and diabetes – For decades the U.S. has had the highest obesity rates across all age groups and adults are among the highest prevalence of diabetes.
  • Chronic lung disease – Lung disease is more prevalent and associated with higher mortality.
  • Disability – Older U.S. adults report a higher prevalence of arthritis and activity limitations.
  • Adolescent pregnancy and sexually transmitted disease – our adolescents had the highest rate of pregnancies and are more likely to acquire sexually transmitted diseases.
  • HIV and AIDS – we have the second highest prevalence of HIV infection among 17 peer countries and the highest incidence of AIDS.
  • Drug related mortality – we lose more years of life to alcohol and other drugs than people in peer countries even when deaths from drunk driving are excluded. In fact the President’s 2014 National Drug Control Strategy noted that drug induced overdose deaths now surpass homicides and car crash deaths.

What’s next? Together we can create the healthiest nation in one generation.

We have a lot of challenges to overcome, but it all starts with a simple first step:

Sign the pledge to show your commitment.  Ask others to sign as well because the more people who sign, the more influence we have to drive change.

Sign the petition to ask our leaders to do their part.  It will take change at both the local and national level to ensure our communities make a positive impact on our health.

ACA Updates

Its been awhile since I have been on here but I do have some important updates related to the ACA Marketplace. IF you currently have a marketplace plan there is important information regarding the 2015 year. There is a great infographic available that will give your steps to staying covered.

5-steps-to-staying-covered

You should also be getting notification of renewal options in the mail. If you have questions you can call us, set up an appointment or email our Navigators
Just a reminder that members of U.S. Federally recognized tribal members can enroll at anytime. For others the open enrollment period starts on November 15th for coverage that will start on January 1st, 2015.

Health Insurance Glossary

There are so many different terms that thrown around and I found this great glossary of terms that I thought I would share with you.

Affordable Care Act: A set of health care reforms passed by Congress and signed into law by President Barack Obama in March 2010. The foal of this law, which is more formally called the Patient Protection and Affordable Care Act and more informally nicknamed Obamacare, was to make affordable quality health care accessible to more Americans. It also aims to give both the insured and uninsured new patient protections to make coverage more fair and easier to understand.

COBRA: Stands for Consolidated Omnibus Budget Reconciliation Act. It allows workers the right to stay on their employer’s health insurance plan for a certain period of time, though they may be required to pay the entire cost of their coverage.

Deductible: A specific amount of money that you must pay before your health insurance will start paying on a health-care claim you have made. This is an out-of-pocket cost. Typically, if you have an HMO, it does not have a deductible (but the trade-off is you are limited to doctors/care providers within that HMO’s “network”).

“Donut Hole”: In Medicare Part D, which covers prescription drugs, most plans have a coverage gap, which is often referred to as the “donut hole”, where coverage is cut off after spending a certain amount and then starts up again after you’ve reached a new threshold of cost. The Affordable Care Act eliminates this gap in coverage by 2020.

Employer-based plans: Insurance plans that are provided by your employer and partially covered by them. This is the type of insurance plan most Americans have.

Employer Mandate: The requirement that businesses with more than 50 full-time employees must offer health insurance to their employees and their dependents under the age of 26, starting in 2015.

Health Insurance Marketplace: The online marketplace where you can search for and purchase health insurance. Also called Health Care Exchange, HIX, Obamacare Exchanges, and Health Benefits Exchange. It’s available at Healthcare.gov

Healthy Kids: A free health insurance plan for children under age 19 and pregnant women. Income requirements do apply.

Individual Mandate: The requirement that all Americans have health insurance in 2014. Those who do not comply face a fine (Some exceptions apply, i.e. Members of federally recognized tribes and others who are eligible for Indian Health Services).

Medicaid: Federal Health care program provided to people whose household income below 133 % of the federal poverty level (Not all states expanded Medicaid, but Michigan did).

Medicare: Federal health care program provided to those age 65 or over and younger people with disabilities.

Medicare Advantage: Medicare benefits provided by a private insurance company.

MIChild: a low-cost health insurance plan for children under age 19. Income requirements do apply.

Minimum essential coverage: The level of health care coverage that all Americans are required to have in 2014 or pay a penalty (some exceptions apply)

Out-of-network: A health care provider with whom your insurance company has not negotiated a rate of payment. See a doctor “out-of-network” can cost you more than seeing a doctor “in-network”.

Out-of-pocket: Expenses you have to pay yourself, above and beyond your insurance premiums. Typically includes copays and deductibles.

Pre-existing condition: A health issue that you already had that would sometimes disqualify you from getting insurance, or would cause your premiums to be increased. Under the new health care reform, insurance companies can no longer discriminate against those with pre-existing conditions or levy additional fees.

Premium: The rate you are charged for having active insurance. It is influenced by various factors and may be paid annually or in smaller installments over the year.

Primary Care Provider: A doctor, nurse practitioner or physician assistant who is the primary person you go to about your health care and is your go-to medical advisor.

Subsidies:Tax credits to help those who earn less than 400% of the federal poverty level buy insurance

Thank you to Health Care Reform + You Magazine for these definitions

Are you a kroger shopper?

If you shop at Kroger you can register your card to benefit American Indian Health and Family Services. We currently have 19 households supporting our organization, so last quarter we had a little over 100 donated to our organization just from these individuals shopping at kroger.

Please register your cards and pass on to family and friends

http://www.krogercommunityrewards.com

Search for American Indian Health and Family Services or Organization # 91936

Facts about the Individual Shared Responsibility Provision

Facts about the Individual Shared Responsibility Provision

I know its been a while since I have posted on here. We have been really busy here at AIHFS with the end of the enrollment period for most people in March and open enrollment of the expanded Medicaid (Healthy Michigan) program. I wanted to share this link with everyone in case you still have questions about the shared responsibility provision of the Affordable Care Act and what it means to you. Remember if you have any questions please give us a call or email as at hbenefits@aihfs.org

Family eligibility for tax credits if you are eligible to enroll in a job-based plan

We have been getting a lot of questions from families where the employer does offer family coverage, but it is often too expensive. Because the employer plan is too expensive, many families are looking to shop in the Healthcare Marketplace (www.healthcare.gov). Even though they are eligible to purchase a plan they are often not eligible for tax credits unless the employee only cost (not the family cost) is more than 9.5% of the family income . This is why some companies are looking at dropping their family coverage. They are starting to recognize that there plans are too expensive for family members and know that families can often get a much better deal through the marketplace if they are eligible for tax credits. If you are one of these families, I encourage you to talk with your employer and see if it is an option to not cover families. Below is some guidance from CMS on the specifics:

Q: Are families eligible for Marketplace tax credits if they are eligible to enroll in a job-based plan that is offered to an employed family member?

A: As explained in greater detail below, the answer depends on whether the job-based plan is considered “affordable” and meets “minimum value.” Employers that offer job-based health coverage for an employee’s family members usually, but not always, pay part of the family’s premiums. If a family chooses an individual health insurance Marketplace plan instead, the employer doesn’t contribute to premiums. Consumers should consider this carefully before comparing Marketplace plans. If a consumer with an offer of employer-sponsored family health coverage decides to shop for Marketplace plans for his or her family, be aware that he or she may not qualify for tax credits (and cost-sharing reductions), even if their household income would otherwise qualify them for financial assistance.

Whether a consumer and/or the consumer’s family members will qualify for tax credits based on income will depend on the coverage the employer offers. A consumer and/or family member won’t be able to get lower costs if the job-based coverage is considered affordable and meets minimum value.

What is considered “affordable?”
A job-based health plan is considered “affordable” if the employee’s share of premiums for the lowest cost self-only coverage that meets the minimum value standard is less than 9.5% of their family’s income.

In other words, if a consumer’s share of premiums for a plan that covers only that person (as the employee)–not his or her family–is less than 9.5% of the family’s income, the plan is considered affordable.

The consumer may pay more than 9.5% of his or her family’s income on premiums for spouse or family coverage from the job-based plan. But affordability is determined only by the amount the employee would pay for self-only coverage from the employer.

For more information, please refer to https://www.healthcare.gov/what-if-i-have-job-based-health-insurance/.

What is the “minimum value” standard?
A health plan meets the minimum value standard if it’s designed to pay at least 60% of the total cost of medical services for a standard population.  In other words, in most cases the plan will cover 60% of the covered medical costs and the person with coverage pays 40%.

A consumer should ask his or her employer for help figuring out if the plan offered meets the minimum value standard. The employer can also give the information needed to determine if the plan is considered affordable.

One way to gather this information is by asking the employer to fill out an Employer Coverage Tool (available here).

 

ACA Exemptions and Benefits for American Indians and Alaska Natives

There have been a lot of questions about who qualifies for the ACA exemptions and benefits as an American Indian/Alaska Native. First of all let me tell you that it is very confusing because the definition of AI/AN in the Affordable Care Act does not meet the definition under Indian Health Services or Medicaid.

Here is what I can tell you:

1) If you are an AI/AN who is a member of a federally recognized tribe:

  • You are exempt from the individual mandate to purchase health insurance
  • You receive the full benefits including: Little to no-co pays/deductibles depending on your income and special open enrollment periods.

2) If you an AI/AN who is not a member of a federally recognized but are otherwise eligible to receive services from IHS including at urban clinics, like AIHFS:

  • You can apply for a hardship exemption through the marketplace (paper forms are currently in development)
  • You do not have access to the benefits such as copays/deductibles or the open enrollment periods.

Remember there are many other types of exemptions available as well, so do not hesitate to contact someone at AIHFS for further clarification or assistance.