Working Together For Michigan Consumers To be Healthy

Benefits for People with Disabilities

Health Reform Fact Sheet

The Affordable Care Act (ACA) increases access and choice in health care

Eliminates discrimination by Insurance Companies.

  • Insurers cannot deny coverage because of pre-existing conditions or medical problems.
    • Starting in 2010 for children.
    • Starting in 2014 for adults.
  • Until 2014, adults can enroll in a state-run insurance option if:
    • They have a pre-existing condition,
    • They have been denied coverage, and
    • Have been uninsured for 6 months. (seewww.HIPmichigan.org or call 877-459-3113)
    • There are limits on out of pocket costs.
  • Expands and Strengthens Medicare and Medicai
    •  Gets rid of spend-downs for many people. Large out of pocket costs will no longer be needed to qualify for Medicaid.
    • In 2014, many more people will qualify for Medicaid. People will be covered if their income is less than 133% of the federal poverty level.* This is much higher than current income limits for adults.
    • In 2013, Medicaid will pay doctors more for primary care services. Payments increase to be the same as Medicare.
    • Insurance plans must cover disability-related services and supplies, such as durable medical equipment, rehabilitation, mental health and substance abuse treatment.
  • More Choices.
    •  Allows individuals to stay on parents’ group insurance plans until age 26. (Retiree only plans are excluded.
    • One-Stop Shopping and Accessibility. Starting in 2014, Exchanges will supply easy to understand, accessible information on available health insurance plans. You can compare and choose the option that is right for you. You will have the same private insurance choices as the President and Members of Congress.
  • New Options for States to Offer Long-Term Care Choices.
    • Creates Community First Choice program. States receive more federal money for offering community-based attendant services and supports. Community First Choice requires a person-centered plan for all assistance.
    • Expands and extends the Money Follows the PersonProgram with extra funding through 2016.
    • Improves the Medicaid Home-and-Community-Based Services (HCBS) option.
    • Gives incentives to states for more home and community-based services as a long-term care alternative to nursing homes.
    • States that now fund less than 50% of long-term services in home and community settings get more money if they increase HCBS by October 2015.
  • More Accessible and Better Quality Health Care.
    • Preventive care: Invests in prevention and public health to prevent illness and disease before they require more costly treatment.
    • Accessible examination equipment: Improves access to medical equipment for people with disabilities to receive care by establishing exam equipment accessibility standards.
    • Health Disparities: Improves data collection on health disparities for people with disabilities, as well as training health providers on serving people with disabilities.
    • Improves Care for Chronic Disease: Promotes better care coordination to improve quality of care.