By Alaina Kennedy

The open enrollment period starts today, Nov. 1, 2017 and ends on Friday, Dec. 15, 2017. The health insurance marketplace is stable despite repeal efforts dominating the news and claims made by Donald Trump.

What you need to know to get enrolled in 2018:

• The 2018 open enrollment period starts today, Nov. 1, 2017 and ends on Friday, Dec. 15, 2017.
• New plans and prices are available each year, and plans may be more affordable than you think. Make sure to shop around.
• Free, local help is available.
  • To find someone in your community certified to sit down with you for free and schedule an appointment for help with the enrollment process, you can call AFC’s informational hotline at 312-784-9060 to speak with a certified in-person counselor who can answer your questions and help facilitate your enrollment into a health care plan. The phone line is open Monday through Friday, 9 a.m. to 5 p.m. CST. In addition, you can visit www.getcoveredillinois.gov and click “Make an Appointment” or you can visit http://www.ilcha.org/help.
• Be aware of scheduled downtimes on healthcare.gov.
• During the open enrollment period, HealthCare.gov will be down periodically for scheduled maintenance. This is unprecedented. Outlined below is a general schedule for planned downtime:
  • Wednesday, November 1, 2017 – overnight
  • Sundays 12am-12pm ET, except on December 10, 2017
  • The duration of the outages are the maximum amount of time allowed for the maintenance. Actual outage times could be shorter.

For more information visit, healthcare.gov or the AIDS Foundation of Chicago’s Open Enrollment Help Center.

Edited by Ashley Slupski

Adapted from the National Immigration Law Center

Hospitals, clinic and other health care settings have a role to play in protecting undocumented communities. 

Here’s what health care administrators should do to provide the best environment to protect the rights of patients and providers:

• Establish a written policy designating private areas and areas closed to the public. Limit access to certain areas only to those who are receiving or providing care, or who are otherwise necessary. 

• Beware of what’s in “public view.” Be cautious of what information is in open view of the public, such as files visible from the visitors’ side of the reception desk.

• Avoid collecting immigration status information. If you must collect such information for a patient, avoid including that information in the patient’s medical and billing records.

• Provide posters and educational materials advising patients that they have the right (a) to refuse to answer questions from immigration agents and other law enforcement and (b) to insist that their lawyer be present if they are questioned.

• Establish a relationship with a local immigration lawyer or attorney, who can be available if an enforcement officer comes to the clinic.

• Designate a specific staffer as authorized and responsible for handling contacts with law enforcement officers.

• Don’t consent; document. If immigration officers ask permission, or attempt, to enter a private area, the designated person should state explicitly that they do not consent to the officer(s) entering without a warrant.

• Review warrants carefully. Remind all patients and other individuals present that they have the right not to answer any questions, other than providing their real name.

• Reassure your patients. Educate and reassure patients that their health care information is protected by federal and state laws.

Immigration enforcement policies and practices under President Trump’s administration are evolving. This post reflects our understanding based on what we know now. Arm your staff and your patients with the knowledge they need to protect everyone’s right to obtain health care.

Want more information? Visit National Immigration Law Center’s hub for health care providers.

By Alaina Kennedy

With Congress giving up on repeal and replace the Affordable Care Act (ACA), for now, the Trump administration stepped in and created backdoor attempts to sabotage the ACA and destabilize the insurance market for people who buy their policies on their own rather than through their employers.

The Trump administration took two actions last week:

Executive Order

On Thursday, October 12, 2017, the Trump administration issued an Executive Order urging the Department of Labor and HHS to issue rules that will undermine the individual and small group health insurance markets, harming consumers across the country.

This executive order lets insurance companies sell junk – junk insurance that is – in the form of association health plans marketed to small companies and short-term insurance marketed to individuals.

The order lets “Association Health Plans” cherry-pick companies with younger and healthier workers, keeping costs down by skimping on covered benefits. Small companies with older or sicker workers would be left behind in their own risk pool, with higher and higher premiums as time goes by. Many companies would be forced to drop insurance entirely, leaving their employees uninsured.

Many people with preexisting conditions, such as those living with HIV, would once again be unable to obtain coverage that meets their needs, as routinely occurred before the ACA.

Cost Sharing Reduction

Last week the Trump administration also announced that it would end Cost Sharing Reduction (CSRs) for insurance marketplace plans.

Trumps decision to pull government funding for CSR payments means insurers are on the hook for these payments going forward.

Insurers must continue providing these CSRs’ who are eligible even though the federal government won’t pay the insurers. That is because the subsidies are a requirement of the ACA. Click here to learn more about CSRs.

Insurers in Illinois assumed CSRs would be cut in their 2018 proposed Marketplace rates (which is why they increased their silver level premiums so much this year), so we don’t think anything will change with those.

The Illinois Department of Insurance said, “‘DOI is committed to ensuring that consumers are prevented from incurring higher health insurance costs due to uncertainty in Washington,’ said DOI Director Jennifer Hammer. ‘Insurers have been advised to apply the CSR uncertainty cost, solely to silver plans.’ This change makes it important that consumers diligently shop for a plan this year. DOI reminds consumers that cost alone may not be the only factor to consider when selecting a plan. For example, consumers may want to also consider a plan’s provider network.”

Experts warned failure to make these payments would raise premiums by 20% or more and add nearly $200 billion to the national debt. Even Sen. Lamar Alexander (R-TN) warned, “Without payment of these cost-sharing reductions, Americans will be hurt.”

However, health care beyond 2019 is very unclear. The Congressional Budget Office (CBO) has said Trump ending subsidies increases premiums by 25% by 2020 and increase the deficit by $6 billion by 2018 and $21 billion by 2020.

To learn more about and stay involved on the Trump administration’s sabotage efforts visit the Protect Our Care and Stand Up To Sabotage website, a campaign to stop Trump’s repeated and ongoing efforts to blow up our health care. 

Jessica Glaspie, 32, is a mom and an advocate living in Lake County. She sat down with her mom, Rosita, to discuss her HIV diagnosis at just 22 years old and her choice to become an outspoken advocate in her community.

The AIDS Foundation of Chicago (AFC) and Legal Council for Health Justice (LCHJ) are appalled to learn the state of Illinois was given a “D-” grade in the National Viral Hepatitis Roundtable and the Center for Health Law Policy Innovation of Harvard Law School’s interactive report grading the nation’s Medicaid programs on their access to treatments for hepatitis C (HCV). Illinois is among the 52 percent of states that received a “D” or “F” in the report issued today.

As the deadliest infectious disease in the U.S., HCV affects an estimated 3.5 million Americans. Approximately 68,400 of those affected live in Illinois and are severely restricted by Medicaid Fee-For-Service (FFS) and the four Managed Care Organizations (MCOs) that require severe liver damage before giving access to treatment. Additionally, FFS, three MCOs and Medicaid Primary Care Case Management (PCCM) require six months of sobriety of active substance users with HCV before giving access to medication.

“Illinoisans with hepatitis C have to wait until they are incredibly sick with major liver scarring before being eligible for treatment under Medicaid at this time,” said John Peller, AFC president/CEO. “With this disease affecting an estimated one in every 200 Illinois residents, it is imperative that access to medication be manageable.”

Because 25 percent of people living with HIV in the U.S. also are infected with HCV, AFC is a strong advocate for the highest quality, most affordable and best access to HCV treatment possible. Earlier this fall, LCHJ and AFC wrote letters to the Illinois Department of Healthcare and Family Services and the Pharmaceutical Research and Manufacturers of America urging the organizations to work together to address the HCV epidemic.

“By Illinois and the country lifting liver damage, sobriety and prescriber restrictions, curing HCV, even among the HIV community, is possible,” said Tom Yates, LCHJ Executive Director. “It’s just a matter of organizations working together to make change happen.”

Media contact:

Charlie Rice-Minoso, PCI
312-558-1770
[email protected]

Despite what you may have heard (or not heard) from the White House, you can still get a health insurance plan from the Health Insurance Marketplace. Open enrollment begins on Wednesday, Nov. 1, 2017 and ends on Friday, Dec. 15, 2017. Make sure you get the best health plan for you by taking the following steps before you enroll:

1. Pay off any balances on your current health insurance. If you owe a back-payment or have a balance you may not be able to enroll in a Marketplace plan for 2018. Call your current plan to see if you owe anything.

2. Open your mail. Health insurers and state officials may send you information about changes to your eligibility, plan or Marketplace. Don’t toss it. Open it right away and save or respond appropriately. If you have questions about what the mail says, and are living with HIV, call AFC’s insurance assisters at 1-312-784-9060.

3. Check your eligibility for Medicaid. Medicaid provides free or low-cost coverage to people with limited incomes. Medicaid isn’t part of the Marketplace and you’ll have to enroll separately. See if you qualify for Medicaid.

4. Renew your ADAP coverage. If you are living with HIV, are eligible for the Ryan White program, and use the Premium Assistance Program, make sure to renew your ADAP certification before you enroll in a Marketplace plan. ADAP certification must be renewed every six months. Ask your Case Manager, Medical Benefits Coordinator or Resource Specialist for help with renewal. Reach out to us at 1-312-784-9060 if you need help.

5. Collect your documents. This includes your Social Security number (if you have one), income information, tax information and information about your current health plan.

6. Call for assistance. If you are living with HIV or eligible for Medicaid, call us first at 1-312-784-9060 to learn which plans might best suit you. The Marketplace Call Center at 1-800-318-2596 can help you enroll in a Marketplace plan 24 hours a day, 7 days a week, or contact Get Covered Illinois at 800-843-6154 to find a local assister who can help.

Open enrollment begins on Wednesday, Nov. 1, 2017 and ends on Friday, Dec. 15, 2017. Make sure you get the plan that best meets your unique health needs.

Few things can more negatively impact a person’s long-term health than being homeless or unstably housed. Fortunately for 100 homeless and chronically ill Chicagoans, there is hope. Two experimental housing programs led by AFC’s Center for Housing and Health (CHH) offer those Chicagoans a fresh start.

CHH is also looking beyond those 100 people whose lives are being transformed. How can it help the growing number of chronically homeless people in Chicago? How can the health care and housing systems come together and support the city’s most vulnerable people?

Two pilot programs — one to house 25 frequent users of University of Illinois Hospital and Health Sciences System (UI Health)  emergency department services; another to house 75 people living in tents under Lake Shore Drive’s north-side viaducts — aim to show success on a small scale, to inspire greater collaboration on wider-impact projects in the future.

“These demonstration projects are designed to bridge the gap between the health care and housing systems by having mutually beneficial goals. We focus on those who are extremely ill and whose health is not improving despite accessing a great deal of health care. We are also providing a home for people who have been homeless – often living on the streets – for many years. Not only do these projects build partnerships between the health and housing sectors, they change people’s lives, “said Peter Toepfer, CHH executive director and AFC’s vice president of housing.

The underlying principle behind these projects is the Housing First model, which says that housing a chronically ill person and providing them with high-intensity, individualized case management helps the patient thrive and saves the health care system significant amounts of money — $6,307 per homeless adult on average, according to a study led by AFC.

Now more than ever, that cost-saving benefit is catching the attention of health care administrators, who seek a way to transition from fee-for-service models (where the health care provider receives payment for each service offered) to outcomes-based payment models (where the provider receives payment if certain health outcomes are achieved). Medicaid-managed care organizations, for instance, are already moving in this direction, says Jessie Beebe, health services specialist for CHH. “The health care industry is now asking the question, ‘How can we use money spent on emergency room care in a different way to keep people healthier in this system?’”

Enter Better Health Through Housing, a collaborative of 28 supportive housing agencies that provide 75% of all supportive housing units in Cook County. They can help a major health care network like UI Health test innovative ways to transition its hospital from fee-for-service to outcomes-based delivery of services.

The agreement makes sense: Supportive housing organizations place clients in their vacant units, and UI Health pays $1,000 per person per month for the support structure and intensive case management those patients need to keep them out of the hospital.

Now, clients who have been chronically sick and chronically homeless are living better lives and saving the health care system money. Emergency department use decreased by 35% and health care costs dropped by 42% among the cohort that is now housed — a sign the program is achieving its goals.

Toepfer shared one story of success: A young man in his late 20s living with schizophrenia and chronic homelessness was a regular user of UIC’s emergency care. His visits were billed to Medicaid. He was identified as a strong candidate for this program because “he needed a home, but it was also important to provide other support like mental health care and case management because he is not getting that support currently.”

After three months of hard work from outreach workers and even his own mother riding the outreach van as they all looked for him in our streets, the man was found and housed. Now, his mental health has stabilized — which is good for him — and his emergency service use and hospitalizations have plummeted — which is good for the health care system.

Chicago Housing Pilot builds on past success and partnerships

The AIDS Foundation of Chicago (AFC) stands in strong opposition to the Trump administration’s announcement to no longer fund cost-sharing reduction payments for insurers. This move is a spiteful display of leadership. Not paying the subsidies will send the health insurance exchanges into turmoil and could take away access to high-quality, affordable health insurance coverage for Illinois families and people.  

After failing numerous times to repeal and replace the Affordable Care Act (ACA) through the legislative process, the Trump administration has reverted to blatant acts of sabotage to dismantle the ACA. The move comes hours after Trump signed an executive order on Thursday aimed at undermining consumer protections in the law. 

The ACA has been transformative for people living with HIV in Illinois. At least 12,000 people living with HIV in Illinois newly gained health care coverage through the ACA. That’s 32% of people with HIV in Illinois, or 1 in 3 of the 37,788 people who are reported as living with HIV in Illinois. In addition, nearly 3,000 people with HIV gained coverage through the health insurance marketplace, and had premiums and out-of-pocket costs paid by the AIDS Drug Assistance Program (ADAP). It is likely that most — if not all — were previously uninsured. 

Tens of thousands of Illinoisans, including working people and families, rely on the ACA’s cost-sharing subsidies to help cover their life-saving treatment, including those living with HIV. These subsidies help health insurance companies pay for out-of-pocket costs that lower-income people and families simply cannot afford. Without these subsidies, insurance companies have one fewer reason to do their job of providing affordable access to health care.

AFC believes this policy shift by the Trump administration is mean-spirited and harmful to the financial and health stability of the country. We demand the Trump administration withdraw this plan; we also call on the Illinois Congressional Delegation, Governor Bruce Rauner, and other elected officials to speak out against this spiteful and mean-spirited act. Together, we can continue to protect the Affordable Care Act and help Americans thrive. 

The 16th annual AIDS Run & Walk Chicago united runners, walkers, community organizations and local celebrities on Sunday, Oct. 1 at Soldier Field to raise awareness for the continued HIV epidemic and funds totaling $480,000 and growing.

Beyond fundraising, AIDS Run & Walk Chicago serves as a memorial for loved ones lost to complications of HIV and AIDS. “For so many of us, we are left without the perspectives of our brothers, lovers, friends, coworkers, parents and neighbors who have died of AIDS-related complications. Their voices and visions have been taken away from us by the most stigmatized disease on the planet: HIV,” announced AIDS Foundation of Chicago (AFC) President/CEO John Peller in an opening ceremony studded with performances from Steve Grand, the Chicago Gay Men’s Corus, Donica Lynn, and an appearance by Hamilton Chicago cast member Carl Clemons-Hopkins. WGN-TV’s entertainment reporter Dean Richards hosted the festivities.

At press time, the event had raised more than $480,000 (gross), which will be distributed among 31 organizations that support people living with and vulnerable to HIV and AIDS in the Chicago metropolitan area.

5k and 10k runners and 5k walkers advanced through the sunny course along Chicago’s Lake Michigan, and winners included the following:

A full list of participant finish times is available at aidsrunwalk.org.

Funds raised through AIDS Run & Walk Chicago will benefit programs and services for the AIDS Foundation of Chicago and 32 other metropolitan organizations that provide life-saving services to people living with and vulnerable to HIV and AIDS. Since it was established in 2001, AIDS Run & Walk Chicago has raised more than $5 million to battle the epidemic.

Fundraising totals for AIDS Run & Walk Chicago will continue to grow, as donations will be accepted throughout autumn. To donate or learn more, visit aidsrunwalk.org or call 312-334-0946.

PHOTOS: aidschicago.org/aidsrunwalk2017

Edited by Ashley Slupski

Adapted from the National Immigration Law Center

The increased threat of deportation causes many immigrants to go without necessary medical services. Here’s how health care providers can protect undocumented patients according to the law:

Want more information? Visit National Immigration Law Center’s hub for health care providers.

• Hospitals and health care facilities are “sensitive locations” and protected from enforcement actions including arrests, interviews, searches and surveillance.
• Health care providers have no legal obligation to ask about or report a patient’s immigration status. Privacy rules prohibits disclosure of patient information without the patient’s consent. Law enforcement officials may request information but it does not have to be shared unless there is a warrant for a specific individual.
• Health providers and patients have the right to remain silent if immigration agents enter a public area of a health care facility without a warrant or the facility’s consent.
• If immigration authorities or other law enforcement officials present a warrant or other court order, it must be signed by a judge and state the address of the specific premises to be searched. Pay close attention and object if officials go beyond the scope of their authority to search or seize objects as specified in the warrant. 
• Health care providers may refuse to consent to a warrantless search of the facility’s private areas unless officers have probable cause” to believe that the search may reveal that unlawful activity is occurring, has occurred, or will occur.

Immigration enforcement policies and practices under the current administration are evolving. This post reflects our understanding based on what we know now. Arm your staff and your patients with the knowledge they need to protect everyone’s right to obtain health care.

Want more information? Visit National Immigration Law Center’s hub for health care providers.