“Health Care For All” has been a battle cry heard in the United States for many years. Fortunately the hope that all people, regardless of their income, will have access to health insurance has become a reality. In 2010 the Affordable Care Act was signed into law.
The Affordable Care Act is aimed at reforming the American health care system. The Act’s main focus is on providing more Americans with access to affordable health insurance and improving the quality of health care and health insurance. The law also expands Medicaid and improves Medicare.
However, there are many problems that Americans face as they attempt to access this proposed affordable care. As of July 1st2014, people living with HIV who receive Medicaid are required to access Florida’s Statewide Medicaid Managed Care (SMMC) – Managed Medical Assistance (MMA) Program. Because of this program, the Agency for Health Care Administration (AHCA) had to change how individuals receive their health care from the Florida Medicaid Program.
Medicaid recipients who must enroll in MMA programs will receive all health care services through a managed care plan. People with limited income, who rely on Medicaid, have many unanswered questions about what exactly the Statewide MMA program will do. Keep in mind that MMA plans will cover services such as doctors’ visits, prescriptions and hospital stays.
Recently, a meeting of people living with HIV, who are receiving Medicaid, was held at Poverello. At that meeting attendees reported that they have been left largely in the dark about what is going on. For example, they stated that they received only a short list of MMA plans to choose from, but they don’t know if their primary care doctors are included in the offered plans. There are no lists available that provide an explanation of what medications may or may not be paid for in these plans (typically called a formulary). There has been no information about whether or not people will have to make co-pays for doctor visits or if there will be co-pays for medications. And lastly no one knows whether or not there will be a monthly premium to be paid for the insurance plan they are required to enroll in. This is a concern because typically managed care insurance requires that a premium be paid.
Fortunately the Broward, Fort Lauderdale HIV Planning Council (HIVPC) has been made aware of these urgent and disturbing issues by the Community Empowerment Committee, which is its consumer advisory group. The HIVPC is reacting to the demand for answers by hosting an upcoming forum with the specific goal of answering these important questions.
Poverello cares about this issue because we serve the people living with HIV who are most likely to be Medicaid recipients. Additionally, Poverello is concerned not only about nutrition and wellness but about the overall health of the people we serve. To that end we are helping to publicize this upcoming forum. Check for the events time and location by going to www.brhpc.org. Click on the “HIV Planning Council” header for all information pertaining to calendars, meetings, and current/upcoming events.