Improving Access to Care in ACA Marketplace Plans

The Epilepsy Foundation is leading advocacy activities at the state and federal level to improve access to care by urging policy makers to address limited benefits, high cost-sharing, and lack of transparency and uniformity in Marketplace plans created by the Patient Protection and Affordable Care Act (ACA).  These barriers make it hard for individuals, especially those living with chronic health conditions like epilepsy, to access the care they need.

The Epilepsy Foundation is committed to the successful implementation of the ACA. Many people, who have been denied access to health insurance in the past because of denials and exclusions for pre-existing conditions, as well as unaffordable premiums, can now gain meaningful access to quality and affordable care. At the same time, new enrollees, especially those with chronic health conditions, are still facing barriers to care, including discriminatory benefit designs that limit access, such as restrictive formularies and inadequate provider networks; high cost-sharing; and a lack of plan transparency that may deprive consumers of information that is essential to making informed enrollment choices.


I Am (Still) Essential

As a leader of the I Am Essential campaign, we brought together more than 300 groups in a July letter sent to HHS Secretary Burwell urging her to reduce barriers to care in Qualified Health Plans offered in the Health Insurance Marketplace. The Secretary recently responded to the letter and once open enrollment begins on November 15th we will have the first opportunity to review the 2015 qualified health plans and see if our concerns have been addressed. The Epilepsy Foundation joined The Aids Institute and the National Alliance on Mental Illness on a release announcing the response form HHS and urging the media to look beyond premiums when covering the issue.

Read the  I Am (Still) Essential Letter to HHS (July 2014)

Read the  HHS Secretary Response to the I Am (Still) Essential letter (October 2014)  

Read the  I Am (Still) Essential Letter to Secretary Burwell Urging Formula Transparency (November 2014)

Read the  I Am (Still) Essential Letter to HHS on the 2016 Notice of Benefits Rule (December 2014) 

Read the  I Am (Still) Essential Press Release for the 2016 Notice of Benefits Letter (December 2014)

Read the  Epilepsy Foundation Comments on 2016 NBPP Proposed Rule (December 2014)  

Read the  Epilepsy Foundation Comments on 2016 Draft Letter to Issuers (January 2015)   

Read the  Epilepsy Foundation Comments on NAIC Model Act on ACA Provider Networks (January 2015) 

Read the I Am (Still) Essential Press Release on 2016 NBPP Final Rule (February 2015)


We are building on the success of the letter through targeted state and federal advocacy activities, and by raising awareness with all stakeholders during the ACA open enrollment season of the need to look #BeyondPremiums when selecting a health plan.


ACA Open Enrollment Runs Through February 15th

With open enrollment season for ACA Marketplace plans running through February 15th, everyone who will be selecting a health plan must look beyond premiums and when choosing a plan. Are you enrolled in an ACA Marketplace plan? Have you faced challenges when trying to gain access to and affording the medications and specialists you need?

We have created a survey to capture this information, which will make it easier for us to raise awareness with federal and state officials about the need to look beyond premiums and improve access to care in ACA Marketplace plans, especially for people living with chronic conditions like epilepsy.

Take a few moments to complete the survey today. 

We’ve also developed a plan checklist to help you understand you health care needs, and gathered additional resources at our page on Getting Started in the Marketplace.


News Stories

Media coverage of the I Am Essential campaign and other ACA News


Getting Started in the MarketplaceTools and resources for searching for and comparing plans in the Health Insurance Marketplace

Affordable Care Act (ACA) BackgroundLearn more about the ACA and the Epilepsy Foundation's advocacy leading up to and after passage of this legislation