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

On May 15, 2015, the I Am (Still) Essential campaign sent the below letter to HHS Secretary Sylvia Mathews Burwell urging her to conduct a thorough review of the 2016 plans and reject those that do not comply with new patient protections included in the most recent Notice of Benefit and Payment Parameters for 2016. More than 215 organizations spoke in a united voice urging improved access to care and plan transparency as well as warning against discriminatory practices such as high patient cost-sharing and excessive use of prior authorization and other medical management techniques.  You can read the letter below.

 

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)

Read the   I Am (Still) Essential Letter to Secretary Burwell on Out of Pocket Maximums (April 2015)

Read the   I Am (Still) Essential Letter to Secretary Burwell on Plan Review (May 2015)

 

Last year, the campaign brought together more than 300 groups in July and December letter sent to HHS Secretary Burwell urging her to reduce barriers to care in Qualified Health Plans offered in the Health Insurance Marketplace.About the Campaign

The I Am (Still) Essential campaign is lead by the Epilepsy Foundation, The Aids Institute, and the National Alliance on Mental Illness, and focuses on improving access to care in ACA Marketplace plans by raising awareness of limited benefits, high cost-sharing, and lack of transparency in Qualified Health Plans. More than 300 national and state groups support the campaign.

 

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