Tuesday, February 24, 2015

Open Enrollment Ends

More Ohioans Are Benefiting from Health Insurance

2015 Open Enrollment (OE2) “officially” ended Sunday, February 15. With 234,507 Ohioans re-enrolling or signing up for the first time for Marketplace coverage, this represents a 51 percent increase over last year’s total.


OE2 Fast Facts:

  • On February 15 alone, more people signed up for coverage than on any other day during this year’s Open Enrollment or last
  • Eight in ten consumers had the option of coverage for as little as $100/month
  • Across the country there are 10 million less people uninsured from 2013-2014


Eligible consumers still have an opportunity to gain Marketplace coverage. 

Last week, three Special Enrollment Periods (SEP) were announced:


“In-line” SEP 

For consumers unable to enroll in coverage through the Marketplace at the end of Open Enrollment (February 15) because of technical issues or long Call Center wait times.

Consumers eligible for the SEP:

  1. Are not currently enrolled through the Marketplace
  2. Have not been terminated from Marketplace coverage during OE2 
  3. Attest that they attempted to enroll during OE2, but did not complete the process (“in line”) by February 15, 2015 because they experienced: 
    1. a technical issue with HealthCare.gov that prevented them from completing enrollment by February 15, or 
    2. an extensive Call Center wait on February 13, 14 or 15
  • This SEP started February 16, 2015 and ends February 22, 2015. 
  • Enrollments completed during this SEP will have a coverage effective date of March 1, 2015. 
  • Eligible consumers can activate the SEP via the Call Center or HealthCare.gov.


Tax-related SEP 

Consumers that found out they must pay the Shared Responsibility Payment (fine) because they did not have coverage in 2014 are eligible for a SEP if they:
  1. Live in states with a Federally-facilitated Marketplace (FFM),
  2. Are not currently enrolled in 2015 Marketplace coverage, 
  3. Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and 
  4. Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes. 
  • This SEP does not apply to consumers who do not have to pay the penalty but are subject to reconciliation and have to repay APTCs. 
  • This SEP begins on March 15 and ends on April 30. 
  • Consumers who qualify must complete the entire enrollment process (that is, including selecting a plan) by 11:59 pm on April 30, 2015.


SEP for consumers that don’t received Medicaid denials until after Open Enrollment: 

If consumers applied for coverage through the Marketplace or Ohio benefits and found out they were denied for Medicaid or CHIP, they may eligible for a SEP. Consumers have 60 days from their Medicaid determination date to renew.



In addition to Ohioans gaining health insurance through the Marketplace, another 471,340 Ohioans enrolled in the Medicaid program through January 16. Last year 526,378 Ohioans enrolled in Medicaid.

Eligible residents can enroll in Medicaid year round.

At this time, many beneficiaries are receiving notices that they must complete and send in the redetermination information required to verify their continued eligibility in the Medicaid Program. Ohio’s FQHC CACs can help with this process. Please click here to find a CAC nearby. (LINK TO PDF OF CACs)



Open Enrollment 3 (2016) dates were released last week. 

November 1, 2015 – January 31, 2016 will give consumers three full months to shop and according to HHS, will “aid consumers in finding a health plan that best suits their needs.”

Rules for OE3 clarify standards for qualified health plan (QHP) issuers to publish up-to-date, accurate, and complete provider directories and formularies.  Issuers also must make this information available in standard, machine-readable formats.

In addition, there are rules around better transparency, premium stabilization programs, formularies, interpreter services and SHOP. The final rule was placed on display at the Federal Register on February 20 and can be found here

Tuesday, February 17, 2015

Talking to Your Patients About Vaccines


It's all over the news and many people are in search of more information.  It is important that if people have questions they get the facts and are not getting the information from an untrustworthy source. It is up to health care providers to provide the facts and evidence to their patients to make sure they are not getting misinformed about the pros and cons of vaccines.   



Health Care Workers aren't the only ones that need to help spread the facts. It is imperative that officials making public statements are getting accurate information from reputable sources before speaking on such subjects. 

AAP released a press release urging public officials to cite credible science when discussing measles stating:

“A measles outbreak has grown to more than 100 people in 14 states. As public officials discuss the outbreak and the immunizations that could have prevented it, the American Academy of Pediatrics urges each of them to research the issue first, using credible, science-based sources of information. It is incumbent on public officials to speak from the facts when shaping public perception and policy. This is crucial when it comes to our children's health and safety.

Getting the measles vaccine is much safer than getting the measles infection… of people who get measles, 1 or 2 in 1,000 will die.”


In the U.S. Department of Health and Human Services' Blog Post "The Fight Against Measles Starts with Vaccination" they stated:

"Measles is still common in other parts of the world and can be brought into the United States anytime by a person who gets infected in another country. In recent years, many measles cases have been brought into the United States from common U.S. travel destinations, such as England, France, Germany, India, and, during 2014, from the Philippines and Vietnam.   Measles spreads easily through the air when an infected person coughs or sneezes. It is so contagious that if one person has it, 9 out of 10 of the people around him or her will also become infected if they are not protected. Pockets of unvaccinated communities are especially at risk for large outbreaks.

While most people in this country are protected against measles through vaccination, the current outbreak highlights the importance of vaccination, as the majority of the adults and children in the outbreak reportedly either did not get vaccinated or did not know whether they had been vaccinated. One thing we are most certain of, the measles vaccine is safe and very effective. Two doses of measles vaccine are 97% effective, and even one dose is 93% effective.

If you are unsure of your vaccination status, talk with your doctor. By making sure everyone is protected against measles, we can help prevent measles from getting a foothold in this country again.



The CDC put together some FAQs about measles for people searching for more information.  They answer questions like these:

Q: Why have there been more measles cases in the United States in recent years?

A: In 2008, 2011, 2013 and 2014, there were more reported measles cases compared with previous years. CDC experts attribute this to:

  • More measles cases than usual in some countries to which Americans often travel (such as England, France, Germany, India, the Philippines and Vietnam), and therefore more measles cases coming into the US, and/or
  • More spreading of measles in U.S. communities with pockets of unvaccinated people.
For details about the increase in cases by year, see Measles Outbreaks.

Q: How effective is the measles vaccine?

A: The measles vaccine is very effective. One dose of measles vaccine is about 93% effective at preventing measles if exposed to the virus and two doses are about 97% effective.








The goal of the Ohio Department of Health (ODH) Immunization Program is to reduce and eliminate vaccine-preventable diseases among Ohio's children, adolescents and adults.  

The ODH Immunization Program seeks to prevent 17 vaccine-preventable diseases (listed below) with  currently available vaccines:

  • Diphtheria, tetanus and pertussis (DTap or Tdap depending on age)
  • Haemophilus influenzae type b (Hib)                
  • Hepatitis A 
  • Hepatitis B
  • Human papillomavirus (HPV)
  • Influenza                     
  • Measles, mumps and rubella (MMR)   
  • Meningococcal  (meningitis) 
  • Pneumococcal  (PCV)   
  • Polio                                        
  • Rotavirus                                 
  • Varicella  (chicken pox)
  • Zoster (shingles- adults only)

Wednesday, February 11, 2015

Act Now to Help Fix the Cliff!

The Time is Now: Congress Must Act to Fix the Primary Care Funding Cliff

Below is a statement from NACHC President & CEO Tom Van Coverden on the President's FY16 Budget Proposal

In his budget proposal recently released, President Obama called for an additional $2.7 billion a year for three years in mandatory funding for Community Health Centers. This amount would be combined with discretionary funding of $1.5 billion and reserve funding from the existing Health Centers Fund. Taken together, the budget calls for funding to support continued operations and services at FY15 levels.

“For 50 years, America’s Health Centers have provided primary and preventive care to those communities and patients who have nowhere else to turn. We have done it by leveraging federal investments into high-quality primary and preventive care, delivering economic impact while saving the healthcare system many times what is invested up front. Thanks to that longstanding bipartisan support, today health centers serve some 23 million patients, including nearly seven million children and more than one quarter million veterans.

However, health centers’ fifty-year legacy of providing access to care is at risk; current mandatory funding for health centers is set to expire at the end of September. Without action by Congress to address the huge shortfall, health centers nationwide would be forced to close sites -- lay off providers and staff, and most importantly, turn away millions of patients in rural and underserved communities. Last year, 250 House members, 66 Senators (including many from the Ohio congressional delegation) and more than 100 national organizations called for a solution, yet with only eight months until the funding expires, it is time for Congress to act.

We are pleased to see that the budget proposal released by the President acknowledges the need for a multi-year solution to the funding cliff. By proposing three years of additional mandatory funding, the President has clearly signaled that maintaining our nation’s investment in health centers must be a priority. Yet with 62 million Americans today without access to primary care, it makes sense not only to keep health centers where they are, but given the increasing demand -- to continue investing in expanded access, better services and higher quality care. The dividends for patients, communities and the healthcare system are enormous.” Read the full press release. Your voice makes a difference – sign up to be a Health Center Advocate today.

View OACHC's Advocacy Resource Webpage here

Thursday, February 5, 2015

'Are You Covered, Ohio?’ Week


Over 202,000 Ohioans have enrolled in private plans through the Marketplace

The week of February 2-6 marks the inaugural, ‘Are You Covered, Ohio?’ week that calls attention to the free assistance offered to Ohioans exploring their health insurance options.

As trusted resources—of care and information—in some of our most underserved neighborhoods, our statewide network of Community Health Centers have assisted thousands in evaluating their options, connecting them to coverage and taking time to offer education on how to use and understand their new benefits.

The good news is that most Ohioans will receive financial assistance to pay for health insurance premiums. Certified Application Counselors at Ohio’s Community Health Centers are trained, unbiased resources that will answer questions and walk consumers through the enrollment process face to face, regardless of whether they qualify for Medicaid or private coverage. Click here to find an Assister near you.  

are you covered? is a statewide effort to connect Ohioans to free information and assistance exploring their health insurance options and enrolling in health coverage. Click here to read a news release to learn more about Ohio’s ‘are you covered?’ campaign.

CACs can view information on open enrollment on OACHC's O&E Resources Page.