Disability, the affordable care act, and health: On the eve of 'going live'

The Affordable Care Act (ACA) provides many provisions that benefit the health of people with disabilities. These provisions include data collection, disability health disparities, disabilities in “cultural competence,” accessible medical equipment standards, the community choice option, and anti-discrimination. In Florida v. HHS, the Supreme Court eliminated mandatory state Medicaid expansion. Most remaining ACA provisions will be implemented in 2014, including voluntary Medicaid expansion and health care exchanges. As ACA implementation begins, new policies have emerged. This presentation looks at the current status of ACA, on the eve of its major implementation, and its impact on disability and health. It examines the states participating in the community choice option, Medicaid expansion, and health care exchanges. It analyzes regulations involved in implementation, disability-specific issues raised during the regulatory process, and steps taken by disability advocates to promote program access. For example, issues arose with people with disabilities and proposed policies for employer-based wellness programs. Also addressed is how 'habilitation' – one of the new ‘essential health benefit' under ACA - will be defined. Issues with co-pays and whether the cumulative effect of multiple co-pays by people with disabilities surpasses the intended ‘nominal co-pays' standard also will be discussed. Participants will gain an understanding of the current status of many of the disability and health issues raised by the imminent implementation of ACA. Should additional legal challenges surface on the eve of implementation, this presentation will provide a legal analysis of the potential impact on the health of people with disabilities.