Health Reform Rundown: Five Years Later

Dear Readers,

It’s been five years since President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010 and we’ve come a long way since then. Prior to the ACA, Illinois women were commonly charged more than men for the same coverage, you could expect to pay more for health coverage if you had a pre-existing health condition, and hundreds of thousands of low-income Illinois residents were ineligible for Medicaid because they didn’t meet criteria (such as having children) that were unrelated to their need for health care.

Five years later, the changes in our healthcare landscape are undeniable. Individuals are now entitled to a range of basic consumer protections, including restrictions on paying more for health insurance premiums because of health status or gender, and nearly 1 million Illinoisans have gained health insurance either through the ACA-created Marketplace or expanded Medicaid coverage. Our state’s uninsured rate has dropped four points to 11 percent.  Nationwide, an estimated 16.4 million previously uninsured Americans have gained health coverage as a result of the ACA.

We wouldn’t have seen these improvements had it not been for the hard work of enrollment assisters, community based groups, and organizations across the state that have educated, enrolled, and helped consumers along the way.  Although much work remains ahead  to create a better health care system that improves health outcomes for all, we look forward to building on the successes we have achieved over the past five years.

Kathy Waligora, Manager, Health Reform Initiative

At a glance: Special Enrollment Periods:ENR_SEP_Infographic_FINAL_021815

Although the Marketplace open enrollment season has officially concluded, there still remain opportunities for certain individuals to enroll in health coverage:

·There is no deadline to enroll in Medicaid coverage. If someone is eligible for Medicaid, they can apply today.

·Individuals may be able to apply for private health insurance through the Marketplace if the qualify for a special enrollment period (SEP). Special enrollment periods are typically triggered by major life events, such as getting married, having a baby, losing employer coverage, or moving to a new region. Check out this screening tool to learn about qualifying for a SEP!

·This just in: Individuals who did not have health coverage in 2014, were subject to the penalty for not having coverage on their 2014 taxes, and still do not have coverage for 2015 may be eligible for a limited special enrollment period. People who qualify for this SEP may apply between March 15 and April 30.To learn more, click here.


In the Spotlight: Tax Credits

Premium tax credits are getting a lot of attention right now, and for good reason. More than  177,000 Illinoisans who purchased health insurance through the Marketplace qualified for a premium tax credit to help them pay maxresdefaultfor their coverage last year. This financial assistance, on average, reduced monthly premium prices for eligible Illinoisans by about $200. During this tax season, these individuals who received financial assistance will need to reconcile their premium tax credit amount on their federal income tax return. For more information about how the Affordable Care Act may affect your taxes, check out this fact sheet, download this flowchart, or listen to a recorded copy of our recent webinar on this topic.

Tax credits are also at the heart of King v. Burwell, a legal challenge considered by the Supreme Court earlier this month. At question in this case is whether residents of the 37 states—including Illinois— that did not set up their own Marketplace websites can be eligible for tax credits. Check out our blog post on King v. Burwell to learn more about the case, the significant coverage gains at stake, and how you can help us prepare for Supreme Court’s decision expected in June.

Our favorite ACA resources:

  • First place to go for anyone who has questions about how to enroll in health coverage in Illinois.
  • HelpHub: Invaluable resource for IL Enrollment Assisters to learn policy updates, download helpful resources, and ask questions about tough enrollment scenarios.
  • Enrollment FAQ’s: From Georgetown University Center on common (and not-so-common) health insurance enrollment hurdles consumers face, and how to overcome them.


What we’re reading:

Obamacare Signups Top 11 Million In Second Year, White House Says

Survey: Illinois uninsured rate in 2014 drops to 11%

16.4 Million Have Gotten Insurance Under Affordable Care Act in Past Five Years


Join us March 26th from 2:00 -3:00 pm for our webinar featuring Out2Enroll and AIDS Foundation of Chicago (AFC), who will be presenting LGBT & HIV Cultural Competency in Health Care Coverage.  Register here!

Be on the lookout for registration information coming your way soon for our April 9th Webinar featuring colleagues from Illinois Department of Healthcare and Family Services who will be presenting on recent and upcoming changes to the Application for Benefit Eligibility (ABE),  the online portal for Illinois consumers to apply for and manage Medicaid, SNAP and cash assistance benefits.  Community-based organizations, advocacy groups, health care organizations, and individuals who assist consumers manage their public benefits may find this webinar particularly useful! Registration information will also be available on our website in the coming days.

Do you work in the Western Chicago Suburbs?  We’re hosting a workshop tomorrow, March 24th from 12:00 - 2:00 pm in La Grange that will provide detailed information on Medicaid managed care and the Affordable Care Act, updates on important policies related to health insurance, and will allow plenty of time for questions and answers with the health policy experts. Space is limited; register here.


In person trainings available for your organization!

·If you have any questions about the ACA or Managed Care, or would like to invite an EverThrive IL staff member to come speak to your organization about health reform, please contact Alicia Siani.

Sunday, March 29, 2015