Access to Care & Treatments

Affordable Care Act

On Tuesday, March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (Affordable Care Act or ACA), a historic health care reform bill, into law. The Epilepsy Foundation has supported health care reform to increase access to insurance and meet the medical needs of individuals with chronic conditions and disabilities like epilepsy. This new law will help to improve the access to medical care and to appropriate treatments, medical needs that have a dramatic impact on the health, family and employment situation for individuals living with epilepsy and seizures.  

The elimination of discrimination in health insurance eligibility, renewal and pricing based on health status is vital to access for people with epilepsy. The provisions will improve access to quality health care for people with epilepsy who are uninsured or under-insured -- including access to insurance for children who age-out of their parents insurance and access to health insurance for young adults and others who may lose insurance when unemployed. Read more about the Affordable Care Act here.


Epilepsy Foundation Comments on the ACA


Patient Protection and Affordable Care Act: On Friday, December 21, 2012 the Epilepsy Foundation submitted official written comments to Secretary of Health and Human Services Kathleen Sebelius on the Standards Related to Essential Health Benefits, Acutarial Value, and Accreditation.The Foundation also provided comments on the Health Insurance Market Rules; Rate Review.

We look forward to the expanded care and benefits that will be provided through the ACA for the millions living with epilepsy, and the Foundation urges HHS to research and clearly address, in policy, the numerous hurdles and restrictions that come with chronic disorders like epilepsy within health care insurance systems.  

Epilepsy Foundation Comments: Epilepsy Foundation comments to the Secretary of Health and Human Services on essential health benefits under the ACA.

Non-discrimination in Workplace Wellness Plans:  On January 25, 2013, the Epilepsy Foundation joined 21 national disability groups on comments to the Department of Labor on proposed rules implementing the Affordable Care Act's (ACA) provision concerning non-discrimination in workplace wellness programs.  While the proposed rules included some protections for consumers, the groups called for clear requirements that wellness programs must comply with the Americans with Disabilities Act. The groups recognize the potential of wellness programs to discriminate against individuals with disabilities, particularly with the use of financial incentives and penalties tied to health status that jeopardize employee's access to affordable, quality health care. Read the letter here.

Essential Prescription Drug Coverage:  On Tuesday, October 2, 2012, the Epilepsy Foundation joined a diverse group of 57 patient advocate organizations to deliver a letter to Secretary of Health and Human Services Kathleen Sebelius, urging the federal government to establish strong prescription drug requirements as part of any regulation that will define essential health benefits unde the Affordable Care Act (ACA). We also ask that the patient protections described in ACA that prevent plans from discriminating against patients, including those with disabilities, be published soon. Read the letter here.

The Epilepsy Foundation, American Academy of Neurology, and the American Epilepsy Society sent a joint disease organization letter to HHS Secretary Sebelius.  The organizations urged the Department in its work on a Notice of Proposed Rulemaking (NPRM) on Essential Health Benefits (EHB) for state-based insurance exchanges under the Affordable Care Act, to at minimum adopt a structure similar to that of the Medicare Part D program in offering access to "all or substantially all" medications in six therapeutic classes affecting conditions such as cancer, HIV/AIDS, kidney disease, mental illness and epilepsy.  Read the letter here

People with epilepsy must have access to and coverage for the care and treatment that works best for them.   Read more about medication substitution issues here. 

ACA in the Judiciary

The Epilepsy Foundation joined an amicus brief (friend of the court brief) in support of the Medicaid program expansion under the ACA. This brief was important not only as a defense of the ACA's Medicaid expansion, but also to prevent a precedent that could damage or infringe on other important federal spending statues, such as the Individuals with Disabilities Education Act (IDEA); Title I of the Elementary and Secondary Education Act, most recently reauthorized in the No Child left Behind Act; the federal foster care and child support enforcement programs ; Title VI of the Civil Rights Act; Title IX of the Education Amendments of 1972; and Section 504 of the Rehab Act, which prohibit various forms of discrimination (racial, gender, disability) by entities that receive federal funds.

 

Epilepsy Foundation Advocacy on the ACA & Court Hearings
The Epilepsy Foundation joined 30 CEOs in a supportive statement released by the National Health Council released during the week of oral arguments calling on the U.S. Supreme Court to uphold the constitutionality of the Affordable Care Act.
 
 
Epilepsy Foundation Reacts to Supreme Court ACA decision.  Read our statement here: PDF or Blog
 
Epilepsy Impact on the ACA decision? Read more here
 
Patient organizations respond to high court decision here.
 
Consortium for Citizens with Disabilities Statement on the ACA Decision: Read about it here.
 
 

Additional References

 

In the States: Find out more about what is going on with health insurance reform in your state.

www.healthcare.gov – Federal Web page for resources on health reform and health insurance needs

www.consumerreports.org/health/insurance/health-insurance.htm -- Online guide from Consumers Union on major marketplace reforms under the new health reform law

http://healthreform.kff.org/ -- Kaiser Family Foundation Health Reform Source online publication        

The following link offers state specific information on health insurance laws, coverage, programs, and consumer issues: http://healthinsuranceinfo.net/getinsured/ -- Georgetown University Guide on Health Insurance