How Republican Plans to Cut Obamacare and Medicaid Hurt Older Americans

Trump on Obamacare

Over the last twelve months, my colleagues and I have spoken at length with close to one hundred Native American seniors across the state of New Mexico about their health care and health insurance. Since November 2016, these seniors have expressed profound apprehension about the future of health care and insurance coverage under President Donald Trump’s administration, both for themselves and for their friends and relatives. As one elderly woman put it, “I have care, but is [Trump] going to take that away from us?”

Most Americans assume that regardless of any changes to the Affordable Care Act (Obamacare), the healthcare needs of seniors will be covered by Medicare, which serves individuals who are 65 years of age or older and who have paid into the Medicare system via payroll taxes. In fact, even if the current Medicare system remains in place, Obamacare repeal will have profoundly harmful effects on older people, especially those under 65 who have low-incomes, live in rural areas, or are in need of long term care or help to stay in their homes. In fact, seniors are among the most likely people to be hurt by plans to replace Obamacare.

How Obamacare Has Benefited Seniors

Seniors age 55 and over make up an increasing part of the U.S. population and their healthcare needs are extensive and complex. The National Council on Aging estimates that 92% of older adults suffer from a chronic illness, such as diabetes or heart disease. Seniors also have high rates of cognitive health problems, including Alzheimer’s and dementia. A growing number of older adults experience mental health and substance use problems. Even as they face such health problems, many seniors have limited incomes and struggle with the costs of housing, food, and health care.

Although Obamacare is often seen as an effort to increase insurance coverage among younger and healthier people, it has also provided numerous benefits to seniors. These benefits are not only endangered by current replacement plans, they appear to be specific targets of Republican proposals. For instance, Obamacare’s prohibition of annual and lifetime limits on insurance coverage – as well as its limits on the ways insurance companies can raise prices for people with preexisting conditions – have made it possible for older adults with a variety of health problems to get affordable insurance and care.

Seniors have also benefitted from Obamacare’s expansion of Medicaid, which extended eligibility to adults at or below 138% of the federal poverty level. According to the Kaiser Family Foundation, more than six million seniors have received new coverage from Medicaid, including older adults under 65, Medicare beneficiaries with low incomes, and seniors who do not qualify for Medicare because they did not pay enough into that program during their working years. This last group includes elderly adults who are homeless or disabled, as well as those who were previously farmers, ranchers, and homemakers.

What is more, Medicaid covers long-term and in-home care services not covered by Medicare. These services allow seniors with serious medical concerns to receive high-quality care, either in a nursing facility or their own homes. In fact, the Kaiser Family Foundation estimates that 6 in 10 nursing home residents are covered by Medicaid.

In addition to extending these critical benefits to seniors, the Medicaid expansion has generated new revenues for providers of healthcare services that many elders need – including mental health and substance addiction services, transportation services, and help to purchase medical equipment needed by adults who wish to remain at home throughout their elder years. These improvements are especially important for seniors in rural areas, where service providers are sparse and patients must travel long distances to find care. As our research in the rural state of New Mexico reveals, healthcare providers report that Obamacare has helped them address the complex health issues faced by aging patients.

Obamacare has also significantly improved Medicare – by ensuring access to no-cost preventive care and screenings and expanding prescription drug coverage. Crucially, Obamacare addresses the previous Medicare gap in prescription drug coverage, where insurance did not pay for drug costs after an individual reached a certain level of costs. Obamacare discounts drug prices for seniors who fall into that coverage gap and aims to close the gap by 2020. Repeal of the law would significantly increase the cost of prescription drugs, disproportionately affecting seniors.

How Republican Plans Will Hurt Seniors Overall

Not only will repealing or reducing core benefits of Obamacare disproportionately hurt seniors, Republican proposals include provisions that will specifically penalize seniors, such as those that would let insurance companies charge older people up to five times more for insurance than younger adults. Families USA estimates that this could put marketplace insurance financially out of reach for 3.3 million people over the age of 55. Proposed caps on lifetime benefits and the elimination of regulations regarding the essential benefits that insurance plans must cover will put seniors at risk of “running out” of coverage as they age or being unable to afford insurance that will actually cover their medical needs.

Whether or not Obamacare is ultimately repealed, cuts to Medicaid – a core part of U.S. health insurance since 1965 — remain likely and will have especially harmful effects on the numerous seniors who rely on the program for long-term care, including the estimated one-third of American seniors who fall below 200% of the federal poverty line. In addition, reductions or caps to federal funding for state Medicaid programs will serve to deepen existing inequities in care for poor, older, and disabled people in the poorest and sickest states.

Better Care for Seniors Helps Everyone

Ultimately, while seniors have specific and complex needs, ensuring their health is important for everyone in all parts of the United States. When older people cannot get health insurance or adequate care, the burdens are often shifted to their adult children and grandchildren. Many seniors also care for their children and grandchildren, many of whom get help from Obamacare’s benefits for all low-income adults and children. Although Obamacare has very real limitations, the prospect of repeal is already plunging seniors into a state of fear and uncertainty. All Americans should join senior citizens in worrying about the drastic downsides for families and communities, especially in rural areas, if current Republican plans become law.

Most New to Medicaid Have No Other Option if Affordable Care Act Repealed

“Lots of Ohioans support the ACA — but where do @ohiogop #OHGOV candidates stand on Medicaid expansion? #SaveACA” via Twitter @kirstinalv

Almost everyone covered through Ohio’s Medicaid expansion would have no other viable insurance option should the Affordable Care Act be repealed, a new study has found.

Law and public health researchers from The Ohio State University determined that 95 percent of newly enrolled beneficiaries would be without a plausible pathway to coverage. The research appears online in the American Journal of Public Health.

“Many of these people have nothing else to turn to,” said Eric Seiber, lead author and associate professor of health services management and policy in Ohio State’s College of Public Health.

“Their choice is Medicaid or medical bankruptcy.”

Ohio is one of 31 states (and Washington D.C.) to expand Medicaid eligibility as part of the Affordable Care Act. The move, which came in January 2014, made eligible those adults with incomes below 138 percent of the federal poverty level. (In 2015, that was about $16,243 earned annually for an individual.)

Prior to the ACA, Ohio generally did not grant Medicaid eligibility to childless adults unless they were pregnant or disabled. Parents qualified for Medicaid only if their family income was below 90 percent of the federal poverty level. By October of last year, enrollment under expansion in Ohio had reached about 712,000 people.

Efforts to repeal or substantially restructure the ACA reforms are under way.

Seiber and Micah Berman, assistant professor of public health and law at Ohio State’s College of Public Health and Moritz College of Law, evaluated data from 42,876 households that participated in Ohio’s 2015 Medicaid Assessment Survey. The telephone survey includes a set of questions to identify coverage immediately before Medicaid enrollment.

The new Ohio State research was driven by this question: “If the ACA is fully or partially repealed, who would lose their coverage and what would happen to them?”

The researchers found that the vast majority would find themselves without insurance in the case of a full ACA repeal.

Though 17.7 percent of survey participants had private health insurance prior to Medicaid enrollment, most had lost their jobs (and their coverage) or were ineligible for employer-sponsored group health plans at the time of enrollment. The researchers found that 4.8 percent of the new Medicaid recipients were eligible for insurance through their jobs, leaving 95.2 percent of new enrollees with no feasible alternative.

Seiber and Berman also found that a rollback would predominantly affect older, low-income whites with less than a college education.

“The impact of insurance is about a lot more than health care,” Berman said. “For people newly enrolled in Medicaid, it means that should they have a major health-related event, they can still pay for food, have stable housing, get out of debt. These are all things that make a huge difference in quality of life.”

A recent Ohio Medicaid analysis, which was conducted with help from Seiber and Berman and mentioned in the new study, found that that the expansion increased access to medical care, reduced unmet medical needs, improved self-reported health status and alleviated financial distress – all results found in other states that have expanded access to government coverage.

The new study shows that the majority of adults newly enrolled in Medicaid did not drop private insurance in favor of the government coverage, Seiber said.

“These are very low-income adults, many of whom lost their jobs and have nothing to go back to,” he said.

Said Berman, “It counters this perception that people have health insurance but then go on Medicaid to save money. That’s just not what the data show.”

That did happen, to an extent, with expansion of Medicaid coverage for children. But that was a different scenario because children’s eligibility begins at much higher family income levels than those in place for new adult enrollees, Seiber said.

Seiber and Berman said they hope the study offers some scientific data that will be useful during discussions of ACA repeal or revision and what it could mean for Americans now covered by Medicaid.

“I don’t think everyone realizes that if you repeal the ACA, that at the same time eliminates the Medicaid expansion,” Seiber said.

One potential weakness of the study is that the researchers were not able to evaluate how many people on Medicaid had the option to move to private insurance – because they were newly employed, for instance – but did not go that route. That type of analysis was not possible with the state-gathered data, Seiber said.

“While it is possible that some portion of these enrollees have since been hired by an employer that offers (insurance), it is unlikely that this would meaningfully improve the insurance outlook for this population,” he and Berman wrote.

The researchers said it’s important to consider the demographics of those covered under Medicaid expansion, including the fact that many are older and already have chronic health conditions that will become more costly and problematic without regular care.

“It’s a really broad cross section, and tends to be older and whiter and more rural than many would expect,” Seiber said.

Americans Divided on Obamacare Repeal, Poll Finds

ST. LOUIS — As House Republicans labor to define a new plan to replace the Affordable Care Act (Obamacare), public support for the 2010 legislation is at an all-time high, according to a national survey taken in January by researchers at Washington University in St. Louis.

“Among Americans in our sample, those opposing repeal now outnumber those favoring repeal, but the margin is small and the divisions are clearly defined by political affiliation,” said Steven S. Smith, the Kate M. Gregg Distinguished Professor of Social Sciences in Arts & Sciences. “The vast majority of Democrats oppose repeal; the vast majority of Republicans favor repeal.”

Summarized in a report issued this week by the university’s Weidenbaum Center on the Economy, Government, and Public Policy, The American Panel Survey (TAPS) polls suggest that most Americans are in agreement about what they like or dislike most about the Affordable Care Act (ACA).

The American Panel Survey (TAPS) is an innovative online survey that seeks opinions each month from a standing panel of about 2,000 people. The TAPS methodology is different from many national polls in that it goes back to the same respondents each month, allowing researchers to analyze how recent trends are influencing the opinions of individual Americans. For more information, including summary reports on interesting new findings, visit taps.wustl.edu.

Among the most popular ACA provisions: prohibiting insurance companies from denying coverage for pre-existing conditions; requiring certain preventative services to be provided without additional out-of-pocket charges; and allowing people to be included on parents’ insurance policies until age 26.

“These features increase the cost of providing insurance coverage and are proving to be a challenge to congressional Republicans’ efforts to create less expensive health insurance options,” said Smith, an expert on congressional politics and director of the Weidenbaum Center.

Meanwhile, a majority of Americans polled also expressed a great dislike for the ACA provision that places a tax penalty on people who remain uninsured, a provision designed to generate revenue and defray costs associated with ACA programs.

“Our findings confirm that the tax penalty for mandated coverage is unpopular,” Smith said.  “While a small majority of Americans oppose repeal of the ACA, the penalty for failing to acquire health insurance is opposed by a plurality.”

TAPS is a monthly online panel survey of about 2,000 people. Panelists were recruited as a national probability sample with an address-based sampling frame.

The survey is conducted by GfK Knowledge Networks for the Weidenbaum Center. Individuals without Internet access were provided a laptop and Internet service at the expense of the Weidenbaum Center. In a typical month, about 1,700 of the panelists complete the online survey.

More information is available at taps.wustl.edu.

Researchers Find Improved Preventive Care From Obamacare Medicaid Expansion

Medicaid proponents rally in Ohio (Credit: Columbus Dispatch)

BLOOMINGTON, Ind. — More Americans are taking steps to prevent disease because of the insurance expansions of the Affordable Care Act, according to a new, groundbreaking study by Indiana University and Cornell University researchers.

With Congress considering the future of the ACA, also known as Obamacare, this research is the first to estimate the impact of the ACA-facilitated expansions of Medicaid on preventive care and health behaviors.

Kosali Simon Photo Credit: Indiana University

Researchers Kosali Simon and Aparna Soni of Indiana University and John Cawley of Cornell University determined that low-income childless adults have benefited in numerous ways from the Medicaid expansions: They are 17 percent more likely to have health insurance, 7 percent more likely to have a personal doctor and 11 percent less likely to report that cost was a barrier to their health care. Their self-assessed health also improved, and they reported fewer days of poor health or restricted activities.

Participants were also more likely to undertake preventive care such as getting a flu vaccination, having an HIV test or visiting a dentist. The ACA mandates that health insurance plans, including Medicaid, cover these preventive services without cost-sharing.

“Our findings indicate that the Medicaid expansions under the ACA succeeded in some of their goals, but other goals remain hard to achieve,” said Simon, a health economist at IU’s School of Public and Environmental Affairs. “More people are seeing doctors and taking steps to safeguard their health. But there’s been no detectable reduction in obesity, smoking or heavy drinking, at least through our study period.”

Conversely, there was no worsening of those risky behaviors; one might be concerned that the newly insured would be more likely to engage in risky behaviors because they now pay less out of pocket for health care. There was no evidence of this phenomenon, which economists call moral hazard, in the data.

The data for the research came from the Behavioral Risk Factor Surveillance System telephone survey conducted by the Centers for Disease Control and Prevention and state governments, through the end of 2015. Thirty states and the District of Columbia expanded Medicaid benefits in 2014.

Their article, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions,” is scheduled for publication in the Journal of Policy Analysis and Management and is available online.

The Presidential Policy Series: Affordable Care Act

Hillary Clinton and Donald Trump clinched the Democratic and Republican presidential nominations.

In less than 18 months, the field of candidates vying to win the 2016 presidential election has narrowed from over two dozen contenders to two major opponents. Now, with fewer than two months before Election Day on November 8th (remember to vote!), we’re exploring the Republican and Democratic candidates’ positions on healthcare policy.

The Presidential Policy Series, we will share where the Democratic and Republican nominees, Hillary Clinton and Donald Trump, respectively, stand on healthcare policy. In this post, we will be discussing the most divisive healthcare issue, the Patient Protection and Affordable Care Act, commonly referred to as the Affordable Care Act (ACA).

The ACA, colloquially known as Obamacare, has been hotly debated for over six years. Advocates and opponents of the law often fall along party line. The law, which represents the largest regulatory change to the industry since Medicare and Medicaid were introduced in 1965, was designed to bring quality and affordable health care to everyone by transforming delivery to focus on value and expanding insurance coverage.

Budget Busting

From a party standpoint, the Republican Party platform views the plan as a “Euro-style bureaucracy to manage unworkable, budget-busting, conflicting provisions.” Many conservatives believe it has raised insurance premiums, increased deductibles, and inflated drug prices while limiting an individual’s access to care within narrow provider networks. Republicans have long called for the law to be repealed, and Mr. Trump, despite previously expressing support for the individual insurance mandate, has fully endorsed a repeal of Obamacare.

In the Trump healthcare plan, he vows to repeal the ACA during his first day in the Oval Office and work with Congress to implement reforms that follow free market trades. He’s specifically mentioned modifying the existing law that inhibits the sale of health insurance across state lines, implementing health savings accounts and individual deduction for health insurance premium payments, requiring full price transparency, and letting states control Medicaid.

Rather than expanding Medicaid, Trump says he’d like to focus on policy that grows the economy and provides more jobs. As his health plan currently states, “the best social program has always been a job – and taking care of our economy will go a long way towards reducing our dependence on public health programs.”

Not Far Enough

Secretary Clinton, on the other hand, has vigorously defended the ACA and has expressed a desire to work with Congress to get legislation passed that would expand aspects of the ACA. Like most Democrats, Clinton believes the health law has been an important step toward the goal of universal health care, for which she has been a longtime advocate.

She introduced the unsuccessful Health Security Act in 1993, which was a comprehensive plan to provide universal health care to all Americans. She later helped create and pass the Children’s Health Insurance Program in 1997, which now provides coverage to more than 8.4 million children.

In the Clinton healthcare plan, she vows to continue these efforts to improve healthcare access.  Clinton plans to work with governors to continue the expansion of Medicaid on the state level and enroll more eligible Americans. She wants to further enact policies that will expand access to affordable health care regardless of immigration status.

Clinton has also called for the funding of primary care services at community health centers to double over the next decade and has expressed support for President Obama’s charge to triple funding for the National Health Service Corps, the government program that aims to address physician shortage in areas around the country. To address health costs, Clinton supports authoritative action to block or modify premium increases, capping prescription drug costs, and limiting excessive out-of-pocket costs for families.

Finally, Clinton has stated that she will pursue efforts to make a “public option” of healthcare possible, and expand Medicare by allowing individuals above the age 55 being able to buy into Medicare program.

New analysis shows 2.5 million Americans currently buying individual health coverage off-Marketplace may be eligible for Affordable Care Act premium tax credits

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HHS encourages consumers to evaluate Marketplace options during upcoming Open Enrollment
Since the Affordable Care Act became law, millions of Americans gained coverage or found more affordable options thanks to premium tax credits available through the Health Insurance Marketplace. Today, the U.S. Department of Health and Human Services (HHS) released data showing that 2.5 million Americans who currently purchase off-Marketplace individual market coverage may qualify for tax credits if they shop for 2017 coverage through the Marketplace. Six states (California, Texas, Florida, North Carolina, Illinois, and Pennsylvania) each have more than 100,000 individuals enrolled in off-Marketplace individual market coverage whose incomes may qualify them for Marketplace tax credits.

“More than 9 million Americans already receive financial assistance through the Health Insurance Marketplace to help keep coverage affordable, but today’s data show millions more Americans could benefit,” said Secretary Sylvia M. Burwell. “We encourage everyone to check out their options on HealthCare.gov or their state Marketplace and see if they qualify for financial assistance. Marketplace consumers who qualify for financial assistance usually have the option to buy coverage with a premium of less than $75 per month.”

Today’s analysis estimates that about 6.9 million individuals currently purchase health insurance in the off-Marketplace individual market. Of those, about 1.9 million either have incomes that would qualify them for Medicaid or place them in the Medicaid coverage gap or are ineligible to purchase Marketplace coverage due to immigration status, while the remainder could enroll in Marketplace qualified health plans (QHPs).

Counting both Marketplace and off-Marketplace consumers, more than 70 percent of all QHP-eligible individuals currently insured through the individual market have incomes that could qualify them for tax credits. If the Marketplace-eligible uninsured are included as well, today’s analysis indicates that almost 80 percent of all Americans eligible for Marketplace coverage could qualify for tax credits based on their income.

Many consumers remain unaware of the financial assistance available to them through the Marketplace. For example, a recent Commonwealth Fund survey found that only 52 percent of uninsured adults were aware that financial assistance is available through the Marketplaces.

Tax credits available through the Marketplace are designed to both improve affordability and protect consumers from the impact of rate increases. Consumers may be eligible if their incomes are between 100 and 400 percent of the federal poverty level (about $100,000 for a family of four). If all premiums in an area go up, the large majority of Marketplace consumers will not have to pay more because tax credits will increase in parallel. A recent HHS analysis – PDF found that, in a hypothetical scenario where all 2017 rates increased by 25 percent, 73 percent of current Marketplace consumers would be able to purchase coverage for less than $75 per month thanks to tax credits.

During the upcoming Open Enrollment, HHS will be placing new emphasis on making sure people currently buying individual market coverage off-Marketplace know their options. For example:

For the first time, our decisions about where to target our outreach efforts – from regional TV and radio to search and digital marketing – will be based in part on where we can reach these consumers, supplementing our continued use of data to target the remaining uninsured.
We are strengthening our relationships with agents and brokers. Agents and brokers are a critical channel for reaching off-Marketplace consumers, who often purchase coverage with the help of an agent or broker. Changes this year, such as offering agents and brokers new Marketplace training tools and faster registration, will make it easier for agents and brokers to enroll people in Marketplace plans. Improvements to agent and broker education and resources will ensure that they and their customers know all their options.

We are working with issuers to provide consumers with more and better information about the Marketplace. This includes updating standard notices to make them shorter, simpler, and more user friendly.

We are making it easier for issuers to facilitate transitions from a parents’ plan into the Marketplace. Specifically, recent guidance from the Department of Labor makes clear that the sponsors of employer plans can – and are encouraged to – provide additional information that will help young adults understand their options and enroll in Marketplace coverage as appropriate.

To read today’s brief, visit: https://aspe.hhs.gov/pdf-report/people-who-currently-buy-individual-market-coverage-could-be-eligible-aca-subsidies

Opportunities for Social Workers Expand Under Obamacare

Millions of Americans breathed sighs of relief upon hearing the Supreme Court’s decision to leave in place subsidies in the Affordable Care Act (ACA) for the insured in states where the federal government created the marketplace exchanges. Six of the nine justices believed it was Congress’s intention to provide a healthcare system that would cover as many Americans as possible. Among those waiting to exhale were social workers who are a critical component in the reformation of the healthcare system under the ACA.

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President Obama reacts to hearing news of the Supreme Court’s decision (Official White House Photo by Pete Souza)

President Barack Obama celebrated the validation of his signature legislative accomplishment with his closest staff. Conservatives were appalled by the decision that—for all intents and purposes—institutionalizes a system they derisively named and now is commonly known as Obamacare.

Most Americans know the law for providing healthcare insurance for millions more Americans through affordable premiums and expanded Medicaid. On a larger scale, the ACA is transforming the entire way we look at health and healthcare.

While discussing social workers involvement in the transformation of the nation’s healthcare system with Dr. Darla Spence Coffey, President and CEO of the Council on Social Work Education (CSWE), she pointed out that since the enactment of the ACA the focus of health and healthcare has moved from individualized medical care to an integrated model that includes behavioral health as well as primary care while factoring in social determinants of health.

This is social work’s approach to healthy living that takes into account the biopsychosocial and spiritual dimensions of human existence. As a result of the new direction for healthcare, there is a greater appreciation of the value social workers bring to the process.

CSWE and the National Association of Social Work (NASW) are partnering on a number of initiatives that will expand social work in healthcare settings. One that includes the Society for Leadership Social Work Leadership in Health Care (SSWLHC) is an agreement with the Centers for Medicare & Medicaid Services (CMS) to train Certified Application Counselors (CACs) to enroll the millions of Americans eligible for healthcare insurance who have not yet signed up. Another initiative funded by the New York Community Trust called Social Work HEALS: Social Work Healthcare Education and Leadership Scholars Program, provides scholarships for social work students at 10 universities.

Social workers are receiving training through the Health Resources Services Administration’s (HRSA) $26.7 million Behavioral Health Workforce Education and Training for Professionals program. Sixty-two schools of social work received $19 million of the funding that will allow about one-fourth of accredited MSW programs to provide scholarships to 4000 students at $10,000 each over the next three years. Additionally, CSWE’s Gero-Ed Center presented a series of five webinars on opportunities for social workers under the Affordable Care Act.

Dr. Coffey says the shift to more integrated healthcare service delivery has spurred greater interest in inter-professional education. CSWE’s annual survey which will be released soon, found that 40 of the 223 masters programs that offer joint degrees reported having a MSW/MPH dual degree option. She reports the number of students specializing or pursuing a concentration in healthcare is on a steady incline. The health and integrated health field setting is the second most common setting after mental health. The health/integrative health and mental health setting for baccalaureate students is now the fifth most populated setting—moving up from sixth last year with 400 more students reported for that setting.

Social workers are regaining influence in discharge planning in hospitals as the determinants of health are understood to be more than a menu list of medications and activities. “There is a greater appreciation for social workers in hospital settings,” Dr. Coffey explained, “because hospitals will be penalized for excessive readmissions under the Affordable Care Act.” The ACA contains a provision that reduces Medicare payments to hospitals with higher readmission rates. Having social workers involved in case management and discharge planning should help reduce the number of readmissions.

The demand for medical or healthcare social workers has increased dramatically. According to the Bureau of Labor Statistics (BLS), employment of social workers is expected to rise by 19 percent between 2012 and 2022, greater than the average of all other occupations combined. While BLS puts the average salary for social workers at $44,200 (2012) annually, they report the average annual salary for healthcare social workers as $53,590 (2013) with some states paying significantly higher wages.

Driving this demand is the aging of baby boomers and the expansion of healthcare by the ACA. Now that Obamacare will remain the law of the land, social workers will play a major role in the transformation of the nation’s healthcare.

Mental Health Advocacy Must Remain A Top Priority

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As of 2013, May is officially mental health month which was set in motion by President Obama, and it has made a huge impact in only a couple of years. This movement has caused other public figures to jump on board to help raise awareness to combat the stigmas associated with seeking treatment. Advocating for mental health awareness is a mindset that we all should aspire to follow.

Although mental health awareness month is officially over, we must be diligent throughout the year in creating awareness on mental illness. Mental health stigmas are a real problem, and they still exist all over the world. In America alone, there are about 8 million people suffering from severe mental illnesses and only around half of those are treated.

But why should we fight these mental health stigmas?

Fear of discrimination and the attached stigmas often keep sufferers and their families from facing their mental health problems. This deters them from seeking help, which is very problematic. Mental health is just as important as physical health.  Additionally, access to mental health treatment and insurance coverage can also be a barrier to seeking treatment. Mental health treatment should be viewed similarly to how physical ailments are addressed because the two are often times entwined.

Fortunately, as awareness of mental health issues spreads and stigmas recede, more and more medical professionals are choosing careers in mental health. We are learning more about the benefits of helping people care for their mental health, including longer life expectancy, increased productivity, improved financial stability, and happier personal lives. As a result, public and private organizations are recognizing the importance of providing access to affordable mental health care. In the U.S., this progress is evident in the inclusion of mental health care coverage requirements in the Affordable Care Act. Read More

What can we do to combat these backwards beliefs?

Simply put, we need to advocate for change. If someone refers to a person with a mental illness as ‘crazy’ or ‘insane’ it is completely justifiable to point out that it is not alright to use such shaming language. It is important to question how using those kinds of harsh words can segue into negativity and generalizations that are frankly not true.

Online communities such as BringChange2Mind and StigmaFighters offer those struggling with mental problems a judgment-free outlet for taking the steps towards acceptance of themselves and overall wellness. Although May is over, advocating for mental health equality must remain a top priority. We all deserve to live happily and feel healthy.

Be a voice of reason by advocating mental health all year-long and you will make the world a much better place for literally millions.

Will the Supreme Court Deal a Fatal Blow to ObamaCare?

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All eyes are on Republicans gaining control of the Senate and affirming their commitment to repealing the Affordable Care Act as known as ObamaCare. However, the decision by four Supreme Court justices to hear arguments in King v. Burwell challenging premium subsidies on healthcare exchanges operated by the federal government could deal a blow to the ACA if the Supreme Court rules against the subsidies. The Internal Revenue Service provides subsidies in the form of tax credits to consumers purchasing health insurance under the Affordable Care Act whose incomes are below 400 percent of the poverty threshold. However, opponents of the law say that wording in the ACA stipulates that these subsidies can only be provided to consumers purchasing health insurance on exchanges “established by states” and that they are not available to people purchasing health insurance on federally managed exchanges.

To date, 13 states and the District of Columbia have established their own exchanges. There are an additional 18 states that have established exchanges in some form of partnership with the federal government. The remaining 19 states are those who have refused to participate in the process and have exchanges run exclusively by the federal government. Much is at stake. According to the Department of Health and Human Services (DHHS) 86 percent of people enrolled through federally operated exchanges rely on the subsidies to reduce their premiums to an affordable level. The Urban Institute estimates 7.3 million people could lose $36.1 billion in subsidies if the Supreme Court strikes them down.

The Supreme Court’s decision to hear the case surprised many because traditionally the Court will only take up a case if there is a split on the issue at the Circuit Court level. The U.S. Court of Appeals for the Fourth Circuit upheld the legality of the subsidies for federally managed exchanges in its ruling in King v. Burwell. However, in another challenge, Halbig v. Burwell, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit ruled against the use of the subsidies. Judge A. Raymond Randolph, appointed by President George H. W. Bush in 1990, and Judge Thomas B. Griffith, appointed by President George W. Bush, voted against the subsidies.

Judge Harry Edwards, appointed by President Jimmy Carter, voted to uphold the subsidies. At the request of the Obama Administration, the full court agreed to revisit the decision. With seven of the 11 authorized judges currently on the court appointed by Presidents Clinton and Obama, it seems likely the full court would support the subsidies effectively eliminating the split. The Supreme Court however decided to revisit King, despite the Obama Administration’s request that it wait for the decision by the full D.C. Circuit Court.

Hardline conservatives saw last week’s evisceration of Democrats during the midterm elections as a fatal blow to Barack Obama’s presidency. They believe he is a lame duck who is weakened both domestically and internationally. They see the Affordable Care Act, which they derisively coined as “Obamacare”, as his only significant legislative accomplishment and it sticks in their collective craw. Although the law remains unpopular with 53 percent of respondents in the Gallup Poll having a negative view of the ACA while 41 percent views the law favorably, it is losing ground as an important concern for the public. According to exit polls most voters in the 2014 midterm election—59 percent—said their vote had nothing to do with the Affordable Care Act compared to 28 percent who cast ballots to express displeasure with the law. During the 2010 midterms 45 percent said they cast their ballots as an expression of their displeasure with the law.

Doomsday forecasts about the Supreme Court’s ruling on subsidies in the Affordable Care Act may very well be overblown. Over at the Washington Center for Equitable Growth—my favorite blog by the way—economist Brad DeLong says even if the Supreme Court rules against federal subsidies, conservatives may not get the results they desire. He believes the 31 states with either state-run exchanges or working in partnership with the federal government will largely be unaffected. He wonders if politicians in the 19 states with exchanges solely operated by the feds will be willing to deny their middle class residents nearly $40 billion in subsidies to purchase health care insurance.

I believe the Affordable Care Act is here to stay. Republicans will waste their time and taxpayers’ money on fruitless attempts to repeal the law knowing full well a law repealing the ACA cannot get past the President’s veto pen and may not get out of the Senate without relying on budget reconciliation as a strategy which is a recipe for disaster. Then imagine what Republicans would do if they could repeal the Affordable Care Act. They have no credible idea about what they would do to replace it.

The Affordable Care Act (ACA) and Preventative Health for Women

 

diverse-group-of-womenThere are several elements of the Affordable Care Act (ACA) that will majorly impact our healthcare system, but one of the most important new provisions is preventative measures for women’s healthcare.  Although certain preventative measures are allowed under the ACA, there are still certain employers who are exempt when it comes to providing contraceptive coverage in their healthcare plans. However, there are plenty of measures that are covered under the plan and will truly benefit women all over the country including well woman exams, breast exams, STI & HIV screenings and counseling and screening and counseling for domestic violence. These types of preventative measures can only provide positive results for women with health insurance.

I can’t help but think about the millions of Americans without health insurance and the women who will not benefit from these services. Breast cancer is the 2nd most common cancer death in women after lung cancer. Over 200,000 women get diagnosed annually and 40,000 die. Early detection can reduce the chances of getting breast cancer and having preventative screenings included in the ACA can reduce the number of women dying due to breast cancer.

STI and HIV Counseling and Screenings

According to the Guttmacher institute, 19 million new sexully transmitted infections (STI) are reported annually and half of these are among 15-24- year olds. It is estimated that 65 million Americans have a viral STI, with the most common one being genital herpes and it is not curable. Most STIs have no symptoms and can be very hard to detect with a doctor’s visit and many people have no idea they are infected with an STI. Some of these STIs, when left untreated, can lead to more serious illnesses such as pelvic inflammatory disease and cervical cancer. Having access to STI and human immunodeficiency virus (HIV) counseling and screenings included in the ACA is extremely important.

In the United States, we have varied opinions on sex, but the reality is our population is not retarding in growth. Sex can be as basic a desire as water, food and oxygen for some Americans. Evidence based research has uncovered that many Americans, especially younger adults and adolescents, do not have access to the factual information about STIs and HIV. In our media, we constantly glorify sex and adolescents are exposed to several television programs that include casual sex with multiple partners.

However, comprehensive sexual health education is not a standard in our country’s public schools. The ACA includes education and information about STIs and HIV, but the hard part is getting people to go to the doctor for this information. With the ACA enacted, there is an opportunity to start encouraging Americans to get annual screenings and to obtain prevention care in order to educate themselves on these issues.

Domestic Violence

One in four women will experience some type of domestic violence in their lifetime, and it is estimated that one-third of female homicide victims that police records have reports of are killed by their intimate partner. This is unbelievable and unacceptable to me. Domestic violence, rape, and sexual violence need to be brought to the forefront of Americans minds. This is a serious issue that needs to be addressed and I believe should be taught in schools along with sexual health information. The fact that the ACA covers screenings and counseling is incredible and this needs to be known. Women may not even know that their health insurance covers these types of things.

Family Planning

This brings me back to the ACA exemptions where certain employers are not required to provide contraceptive counseling and prescriptions. If employers, even those with religious beliefs do not support contraception, want a diverse body of people to be employed at their organization, they need to provide diverse healthcare plans that not only include basic health care, but specific healthcare pertaining to women including contraceptive coverage. It is estimated that nearly 99% of all women have used some sort of contraceptive method in this country.

Birth control can prevent unplanned pregnancies and abortions which saves our country money. Not all women want kids, so having these options are vital to their healthcare plans. Overpopulation is our number one social problem in this country, and it leads to many other issues including water shortages, food shortages and a large population of children being placed into foster homes or adoption agencies because of unplanned pregnancies. Having birth control be easily available and affordable will go a long ways toward prevention.

Income Inequality

Additionally, we must touch on is the gap between the rich and poor and how hard it is for millions of Americans to even obtain affordable health insurance. The ACA is a large step towards providing healthcare to the uninsured in our country, but it needs to be expanded further. It’s not perfect and many Americans are being caught in the Medicaid gap where they don’t make enough money to qualify for subsidy, yet they are in a State which refuses to expand Medicaid. If more Americans can received annual checkups and screenings, many may be able to identify and access preventive care to prolong life. Right now, it seems that the majority of Americans only go to the doctor when it is an emergency which needs to change.

Preventative healthcare is one of our country’s solution to address our nation’s growing healthcare problems. Hopefully, the ACA will lead to more systematic healthcare reforms in order to change the ways our country handles health issues and social problems. Feel free to share this with organizations that work with adolescents, schools, sexual health clinics, etc.. BeYouBeHealthy.org 

Does Obamacare Benefit Baby Boomers?

Baby boomers, born between 1946 and 1964, are changing the definition of what it means to grow old. Baby boomers don’t want aging services the same way their parents did, boomers don’t want senior centers and adult day care centers, they want wellness centers and spas. They don’t want to be isolated in nursing homes, they want to live in active communities. They don’t want to stay home and watch Gunsmoke reruns in their moo moo, they want to go out dancing in high heels wearing Gucci. Boomers are spearheading the movement to age in place and our health care policies are following.

Obama_healthcare_signatureThe health home model of service delivery in section 2703 of the Patient Protection and Affordable Care Act is the most recent federal initiative promoting integrated health care and aging in place. The Patient Protection and Affordable Care Act (H. R. 3590) is a federal policy that signed into law by President Obama in 2010, also referred to as Obamacare.

Section 2703 of the Affordable Care Act authorized states to develop a system of coordinated care through a health home. The health home facilitates access and coordination of health services through home health care, including primary health care, behavioral health care, and community-based services for Medicaid recipients with a chronic condition.

Health homes are of particular importance to older adults since the passage of the Affordable Care Act means reducing health disparities for older adults. For example, the barriers that prevent screening and assessment, and treatment among all older adults have a larger greater impact on homebound older adults due to transportation issues, handicapped accessibility, and isolation. Homebound older adults have greater physical health issues, and therefore, seeking treatment for chronic health conditions presents a significant barrier.

The passage of the Affordable Care Act, Obamacare, brought increasing recognition of the need to consider the totality of an individual’s health and health care. This means fostering overall health and wellness by promoting the integration of behavioral health (mental health and substance abuse) and primary health care to increase access to affordable and effective integrated health care, treatment, and recovery support services.  Within this context, now is a perfect opportunity to engage stakeholders and partners to embrace recovery and all of its dimensions.

However, as the baby boomers redefine what it means to be “elderly” or “senior”, what will this new healthcare system look like for older adults? The home health model is an idea that promotes aging in place. It hasn’t been researched fully to know the benefits of this system. More research needs to be done, but what do you think, is the home health model truly of benefit to older Americans?

For more posts like this, follow me on Twitter @karenwhiteman

Social Work White House Briefing Presentations Now Available

As previously reported, Council for Social Work Education joined with the White House Office of Public Engagement on September 25 in hosting the White House briefing “Addressing the Social Determinants of Health in a New Era: The Role of Social Work Education.”

Presentations from the event are now available. Follow the links below to access the presentations of a number of Obama administration officials:

White House Briefing
Aaron Bishop and Roslyn Holliday

Roslyn Holliday Moore, MS, Office of Behavioral Health Equity, Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services (HHS)

  • PowerPoint Slides (PDF) 

Aaron Bishop, MSSW, Deputy Commissioner, Administration on Intellectual and Developmental Disabilities, Administration for Community Living, HHS

Data used for prepared remarks:

•         Visualizing Health Policy (Kaiser Family Foundation)

•         Americans With Disabilities 2010 (Census Bureau)

•         Census and Disability (Census Bureau)

The New Expectations of Health Care

Stephane Philogene, PhD, Associate Director, Office of Behavioral and Social Sciences Research, National Institutes of Health, HHS

  • PowerPoint Slides (PDF)

A National Dialogue on Mental Health

Brian Altman, JD, Legislative Director, and Paolo del Vecchio, MSW, Director, Center for Mental Health Services, SAMHSA, HHS

  • PowerPoint Slides (PDF)

Building Workforce Capacity to Meet the Need

Marcia K. Brand, PhD, Deputy Administrator, Health Resources and Services Administration (HRSA), HHS

[gview file=”https://swhelper.org/wp-content/uploads/2013/11/Panel4-SocialWorkWHBriefingslidesbrand.pdf”]

Source: Council for Social Work Education

Press Release: Social Work Helper Magazine was not involved in the creation of this content.

Government Shutdown Is Over But What Does It Mean

After 16 days of a government shutdown, the House finally allowed a vote which resulted in the passage of bi-partisan bill to reopen the government and avoid default. The 285 votes that decided to reopen the government was comprised of a unified democratic block and several moderate Republicans. However, the 144 votes to keep the government closed and not raise the debt limit were all cast by Tea party Republicans.

Since the government shutdown begin, Democrats and Senate Republicans have openly advocated for the suspension the Haster Rule which requires the “majority of the majority support” before a bill can be brought to the floor for an up or down vote. However, Speaker Boehner has refused to suspend the rule for 16 days stating there were not enough votes to pass a clean continuing resolutions to reopen the government and raise the debt limit. What was the purpose of keeping the government shutdown for 16 days, furloughed workers, and denying needed services to vulnerable populations? What did House Republicans get from shutting down the government other than an opportunity to do it again in another 90 days?  Not only could Speaker Boehner have ended this crisis weeks ago, he could have possibly prevented a government shutdown all together by allowing a vote on a clean resolution or on a budget that has already been passed by the Senate.

According to statement released by Speaker Boehner on Wednesday hours before the default deadline, he stated:

“Blocking the bipartisan agreement reached today by the members of the Senate will not be a tactic for us. In addition to the risk of default, doing so would open the door for the Democratic majority in Washington to raise taxes again on the American people and undo the spending caps in the 2011 Budget Control Act without replacing them with better spending cuts,” House Speaker John Boehner, R-Ohio, said in statement Wednesday afternoon. “Our drive to stop the train wreck that is the president’s health care law will continue. We will rely on aggressive oversight that highlights the law’s massive flaws and smart, targeted strikes that split the legislative coalition the president has relied upon to force his health care law on the American people.”  Read Full

In the deal to reopen the government, the agreed upon terms will fund the government until January 15th 2014 and extend the debt ceiling until February 7, 2014. Republicans also added a provision to be instituted into Obamacare which would require income verification prior to receiving a federally subsidized health care plan. President Obama gave a speech to address reopening the government as well as reestablishing the trust of the American People. Prior to leaving the briefing room, a reporter shouted a question at President Obama asking if we will be back at another government shutdown in 90 days. His answer was simply, “No”.

View the President Speech below:

[youtube]http://www.youtube.com/watch?v=hAnRik_DTzA[/youtube]

What If Walter White on Breaking Bad Had Obamacare

It’s been 16 days of a government shutdown because Democrats refused to defund Obamacare, and Breaking Bad had its final episode ending what is sure to be a cult classic. These are perilous times we are living in and will no doubt be remembered through the ages. However, these two catastrophic events colliding together got me to thinking. What if Walter White, the main character in Breaking Bad, had Obamacare when he was first diagnosed with terminal Cancer?

For those who may not be fans or followers of the show, Breaking Bad was a mega-hit AMC series about a high-school Chemistry teacher, Walter White played by Bryan Cranston, who was diagnosed with terminal Cancer. At the time of his diagnosis, Walter had a pregnant wife and a teenage son with cerebral palsy. Although Walt had HMO coverage through his employer with the public school system, his coverage did not pay for the specialist he needed which was out of network. As a result, Walt got the bright idea to start cooking crystal meth to pay for medical expenses and stack the proceed of his drug sales to secure a financial future for his family after his death.

ABC News also did an investigation of how Obamarcare could have made Breaking Bad less bad.

Walt’s family prevails on him to go outside of the network to see a super-star specialist who charges accordingly. After more than one costly hospital stay, Walt winds up owing some $200,000. That’s far beyond the provisions of his HMO.

In the pre-Obamacare world, he was stuck with having to pay that out of pocket. How would his life have been different, though, under the Affordable Care Act?

Better, thinks Geoffrey Joyce, an associate professor of pharmaceutical economics and policy at USC–much better.

“If Walt opted out of his employer’s coverage,” says Joyce, “he could select a plan from his state’s insurance exchange that included his preferred physician and hospital in its network. In addition, if Walt’s household income was less than 400 percent of the federal poverty line (or $88,000 for a family of four), which is likely for a high school teacher in Albuquerque, New Mexico, he would be eligible for subsidies—both premium subsidies and cost-sharing reductions.” Read Full Article

Even though Walter White and his family are fictional characters, health care in this country is causing families to find creative ways and possibly illegal ways to support themselves during a medical crisis. The Affordable Care Act is one step closer to removing barriers families face in the spiral to bankruptcy and foreclosure as a result of an illness.

The Department of Health and Human Services have put together videos, webinars, tool kits, and state by state fact sheets to help you better understand the changes being implemented. View all resources using this link: http://www.hhs.gov/opa/affordable-care-act/index.html

Here is a 9 minute recap of all five seasons of Breaking Bad. Enjoy!

[youtube]http://www.youtube.com/watch?v=ovlK-WXJ-pQ[/youtube]

Lawmakers Arrested: March on Washington for Immigration Reform

With the government shutdown, gun control, and the roll out of Obamacare, immigration reform appears to have taken a back seat on the minds of lawmakers. What was once thought to be a foregone conclusion after the 2012 Presidential Election, many Americans believed immigration reform would receive a swift passage into law. Unfortunately, House Republicans have continued to use stall tactics, investigative committees, and prevention of a vote to keep pending immigration reform legislation from becoming law. On October 8, 2013, approximately 10,000 protesters ascended on the US Capitol to demand immigration reform which resulted in several dozen arrest that included 8 members of Congress.

According to MSNBC News,

Democratic members Charles Rangel, Al Green, Jan Schakowsky, Luis Gutierrez, John Lewis, Raul Grijalva, Joe Crowley and Keith Ellison were removed in plastic cuffs after blocking a street as onlookers cheered “Si se puede!”

The rally, organized by a coalition of immigrant rights groups and labor unions, featured speeches from dozens of politicians. Among the speakers was Nancy Pelosi, who recently joined Democratic members in introducing a new comprehensive immigration bill modeled on the Senate’s already-passed proposal. Many attendees carried signs or chanted slogans encouraging the House to hold a vote on the bipartisan Senate bill, which would have provided an earned path to citizenship for some undocumented immigrants over a 13 year period.  Read Full Article


https://twitter.com/repjohnlewis/status/387686060446076928/

On October 5, 2013, a National Day of Dignity was held in cities around the country with immigrant communities, faith leaders, labor organizations and more. The rallies were held to call on Congress to pass comprehensive immigration reform now. Republicans promised to work with Democrats in order to create a plan for comprehensive immigration reform. The Senate did its job and passed a bill that wasn’t perfect. However, it was a start towards removing barriers for some like the Dreamers who are caught in an undocumented limbo.

We are marching for commonsense immigration reform with legalization that leads to citizenship, legal immigration rules that promote family unity and protect worker rights, an end to the destruction of our families through deportations, and a halt to the rush towards massive wasteful spending on unneeded border militarization and for profit immigrant detention prisons.

We are marching for an America where our hard work is honored; where our many contributions to the nation are respected and where our families and children can dream of building lives of dignity and without fear. We cannot let the continued failures of Washington result in more families torn apart, more abusive employers and poverty wages, more children who cannot dream. October Immigration


Photo Credit: Courtesy of Yahoo News

Government Shutdown: Why Can’t the White House and Congress Get Along?

US Capitol

I have found that negotiation and mediation are advocacy tools that successful social workers use to bring about change within individual client systems as well as in policy making. Social workers sometime use creative advocacy techniques that may extend beyond traditional channels in order to protect their clients from harm while balancing organizational policies and procedures that often restrict their ability to do their jobs.  

The government shutdown over funding the Affordable Health Care Act, commonly known as Obamacare, reminds me that strong advocacy is often adversarial and can have negative consequences. What happened to using negotiation and mediation as advocacy tools?  While there are many benefits to Obamacare, few would dispute there is much opposition to the law and full implementation. Mediation is a viable and evidenced-based process for resolving disputes peacefully and collaboratively.  Why take the American people hostage?

Perhaps it’s time for each of us to become mediators. I would like to ask everyone who reads this column to become an armchair mediator with a fair and impartial in examining the government shutdown dispute. Before we can assume the role of armchair mediators, we must first put aside our political affiliations as well as our position on Obamacare to be objective in the matter.  We need to honestly ask each of the parties  “What if you are absolutely right, where do we go from here?”

A mediator would ensure all stakeholders, not just the loudest voices, at the table were heard. The politician, the everyman…Mediators ask difficult questions: for example, where is the opportunity for common ground and how do we respectfully acknowledge opposing points of view?  Read More

In my inaugural column for the Social Worker Helper, my hope is to share my expertise as a mediator  for over 30 years and highlight the use of mediation and negotiation as advocacy tools.  All opinions are valued.

Which Is Better Obamacare or the Affordable Care Act

Last time I checked, Obamacare and the Affordable Care Act was the same thing. However, Jimmy Kimmel was able to show that some Americans love the Affordable Care Act, but they hate Obamacare because it forces people to buy health insurance. In a segment where Jimmy hits the streets, he quizzes random pedestrians on current news worthy events, and the responses he often receives are quite hilarious. According to Yahoo News:

A recent CNBC poll found 46 percent of respondents said they are opposed to Obamacare. But only 37 percent of the same people taking part in the poll say they oppose the Affordable Care Act.

“I just think there’s a lot of holes in it and that it needs to be revamped. I just think it hasn’t been thought out,” one person says when asked why she doesn’t like Obamacare. When asked about the Affordable Care Act, she responds, “It’s better but I’m not happy with that, either.”

“Just the name says it all,” adds another man, who said he’d sign up for the Affordable Care Act but not Obamacare.  Read More

After the government shutdown on midnight October 1st, Obamacare immediately went into effect at 12:01 AM. Although the healthcare.gov website for signing up with the exchanges experienced some glitches, 1 million people had logged onto the website before 7AM. By noon, over 2.8 million people were looking to get quotes on a new healthcare plan. Despite the website’s launch getting off to a rocky start, there sure are a lot of people interested in Obamacare.

The Department of Health and Human Services have put together videos, webinars, tool kits, state by state fact sheets to help you better understand the changes being implemented. View all resources using this link: http://www.hhs.gov/opa/affordable-care-act/index.html

The Clock Strikes Midnight and Obamacare Did Not Disappear

Obamacare entered into its full implementation phase at the stroke of Midnight on October 1st, and it did not disappear as John Boehner and the GOP had hoped. Healthcare.gov immediately went active allowing the creation of accounts for uninsured Americans to begin applying for healthcare plans. Despite Tea party Republicans’ efforts to defund Obamacare, the Affordable Care Act is still the law of the land and implementation is being rolled out as planned.  However, they did manage to accomplish a government shutdown which will affect over 800,000 federal employees and a host of government services around the country.

Last week, I had the opportunity to attend the first ever White House Briefing specifically for social work professionals. We received lots of resources and tool kits that I will be sharing in a series of articles to help consumers, helping professionals, and small businesses better understand the benefits as well as addressing the myths of the Affordable Care Act (ACA).

In an article written by the Congressional Research Institute for Social Work Policy, it eloquently captured the essence and purpose of the briefing:

White House Briefing 044Led by Council of Social Work Education (CSWE) President Dr. Darla Spence Coffey, about 160 social workers were enthusiastically welcomed into the historic Dwight D. Eisenhower Executive Office Building today for a White House briefing for social workers titled:Addressing the Social Determinants of Health in a New Era: The Role of Social Work Education.  Several senior White House officials participated in four panels addressing the importance of social workers as the Patient Protection and Affordable Care Act moves into a new phase October 1, when the health insurance exchanges are open for business.

This was a day when those of us fortunate to receive an invitation could be especially proud to be social workers.  It was a day when the value of our training and our contributions were recognized in a major way by the Obama Administration.  We were greeted by Paul Monteiro from the White House Office of Public Engagement headed by Obama Administration Senior Advisor Valerie Jarrett.  He acknowledged the importance of the critical roles social workers must play to ensure the successful implementation of the Affordable Care Act.  Read Full Article

Consumers, small businesses, and helping professionals can also get  information directly from the Healthcare.gov website as well as its twitter profile using the hashtag #getcovered and #healthplans. Obamacare will not only connect you with healthcare plans, but dental plans are also an option:

Want to learn more about some of the main provisions of Obamacare? View the video below:

 

Photo Credit: Cinderella Courtesy of Disney; Darla Coffey at White House Briefing taken by Deona Hooper, MSW

Tea Party Dominance Causes Government Shutdown

government shutdownIt is shortly after midnight, and a government shutdown is now reality. Republicans have refused to pass a budget or continuing resolution unless Democrats agree to defund or further limit Obamacare which has led to the first government shutdown in 17 years. It appears Texas Senator, Ted Cruz, is leading tea party Republicans in their disdain for Obamacare. However, their efforts have done nothing to prevent full implementation of the Affordable Care Act which also went into effect at 12:01AM.

Hours before the government shutdown, President Obama signed a bill that would ensure military personnel would not be affected. Unfortunately, the government shutdown will affect over 800,000 federal employees who are not considered essential employees. President Obama recorded a video message to our troops which can be viewed below:

[vimeo]http://vimeo.com/75834646[/vimeo]

You can read the full text of the President’s speech below:

Hi everybody. As President and your Commander in Chief, I’ve worked to make sure you have the strategy, the resources and the support you need to complete the missions our nation asks of you. Every time, you’ve met your responsibilities and performed with extraordinary professionalism, skill and courage. Unfortunately, Congress has not fulfilled its responsibility. It has failed to pass a budget and, as a result, much of our government must now shut down until Congress funds it again. Secretary Hagel, General Dempsey and your commanders will have more information about how this affects you and your families. Today, I want to speak directly to you about what happens next. Those of you in uniform will remain on your normal duty status. The threats to our national security have not changed, and we need you to be ready for any contingency. Ongoing military operations—like our efforts in Afghanistan—will continue. If you’re serving in harm’s way, we’re going to make sure you have what you need to succeed in your missions. Congress has passed, and I am signing into law, legislation to make sure you get your paychecks on time. And we’ll continue working to address any impact this shutdown has on you and your families.

To all our DOD civilians—I know the days ahead could mean more uncertainty, including possible furloughs. And I know this comes on top of the furloughs that many of you already endured this summer. You and your families deserve better than the dysfunction we’re seeing in Congress. Your talents and dedication help keep our military the best in the world. That’s why I’ll keep working to get Congress to reopen our government and get you back to work as soon as possible.

Finally, I know this shutdown occurs against the background of broader changes. The war in Iraq is over. The war in Afghanistan will end next year. After more than a decade of unprecedented operations, we are moving off a war footing. Yes, our military will be leaner, and as a nation we face difficult budget choices going forward.

But here’s what I want you to know. I’m going to keep fighting to get rid of those across-the-board budget cuts—the sequester—which are hurting our military and our economy. We need a responsible approach that deals with our fiscal challenges and keeps our military and our economy strong. And I’m going to make sure you stay the greatest military in the world—bar none. That’s what I’m fighting for. That’s what you and your families deserve.

On behalf of the American people, thank you for your service, which keeps us free. And thank you for your sacrifice, which keeps our nation – and our military – the greatest force for freedom that the world has ever known. God bless you and your families, and God bless the United States of America.

How the Affordable Health Care Act is Saving My Life-Part I

I knew that pursuing this degree would be costly, but what I didn’t know is that it could potential cost me my life. Three years ago, I was accepted to one of the top five Schools of Social Work in the country.

I was already working as a Child Protective Services Investigator when I decided to pursue my MSW, and I thought it would help me to advance in my field. However, as a CPS investigator and a Master level student, I was forced along with others in my cohort to make a decision between finishing school and my job. Both worlds were colliding, and I was caught in the middle.

It’s crazy how a social work student with no work experience can work in Child Welfare to fulfill their 900 hour internship requirement. However, someone already working in Child Welfare doing the same job does not receive credit and is required to do an additional field placement. In what world is this fair!

I was already invested in both time and money to just walk away from school. So, I quit my job working at a Human Service Agency in order to work for free at another Human Service agency in order to fulfill my internship requirements. As a working practitioner, I knew that I could not manage my caseload, class work, and another 16 hour per week internship to be completed in another department. Initially, my agency was going to give me some concessions while in school, but all it takes is for someone to quit or go on FMLA.

Yes, I knew that I had a pre-existing health condition, but I was going to a university with one of the best health care systems in the country. It never occurred to me, not even once, that the program in which I was accepted would not offer me a healthcare plan.

The summer before my last semester, I started getting sick. Everyday, I would park in the deck of the Medical Center to walk to class at the School of Social Work while I was being relegated to free clinics for my health care. The last semester, my school made some changes to the health care plans. I have a healthcare plan…. Now, I can get the care that I desperately need. Right? Wrong!!!

The health insurance provider stated that I needed proof of continuous coverage in order to receive coverage because I had a pre-existing condition. Guess what….I didn’t have proof because I had been uninsured for a year. Ok….I thought. I am an advance standing student….I will be back to work in no time. Everything will be alright. Right? Wrong!!! It would be a year after graduation before I would gain employment and health insurance again.

Two years and one pre-existing condition later, in May 2012, I began getting the tests I needed years ago to determine whether I have cancer or not. Not having health insurance in this country is a death sentence. In the last six months, I know two African-American women who died from complications from preventable issues because they did not have health insurance. Despite my degrees and my accomplishments, I was just another unemployed, black woman with no health insurance, and I was treated as such.

Today, my insurance carrier is covering the majority of cost for my tests and surgery, and I don’t think it would have been possible without the ACA. With health insurance, I have Dr. Randall Scheri the world-renown surgical oncologist at Duke University Cancer Center performing my surgery later this week. The prognosis is good because the cells have not turned cancerous….Thank God!!! They are taking every precaution in case something is found during the surgery. However, I believe everything is fine, and I am planning for a speedy recovery.

President Obama made it possible for those without healthcare to have the ability to get health insurance and be covered. He did it despite the difficulty and the unpopularity of the bill, and I am thankful that he did. Now, my hope is that the Council for Social Work Education will reform their current internship requirements, so it is not oppressive and create further hardships on students who just want to help others. No other profession mandates a 900 hour unpaid internship with no guarantees of health insurance in order to obtain a degree. So why is social work doing it?

It’s been difficult to not be bitter and not to be angry. No one should have to choose between basic human needs in order to pursue higher education for a better life. After my surgery and I am on the road to healing, I plan to advocate on behalf of students who may find themselves in similar situations or for those who may choose not to go back to school for social work because of the barriers. Change is needed.

*Part II soon to come…

Captain’s log stardate 74906.5, June 10th, 2021, Part II was never written. Cancer was found during the surgery, and it has been a long journey to recovery. However, this platform would not have been created without that experience. I use this platform to create awareness and advocacy on a variety of issues, but at its core, our goal is to help register people to vote on the matters important in their lives and their loved ones.  I am a firm believer that pain and suffering breed empathy and compassion. As a result of my pain, it further ignited my desire to help more people navigate their pain as well as support their purpose.

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