Implementation of the Affordable Care Act
Signed into law on March 23, 2010, the Affordable Care Act (ACA) contains numerous provisions impacting a wide range of health care related issues. The overarching goals of the legislation were to increase the number of people with insurance coverage, improve the design of existing policies, and increase the quality of care provided in the U.S., all while taking significant steps to control costs.
Key issues for midwives include:
- Increasing Medicare reimbursement for midwives to 100% of that received by physicians
- Requiring Medicaid programs to provide coverage for birth center services and the services of providers working in birth centers
- Expansion of the eligibility criteria for Medicaid
- Creation of the new Health Insurance Marketplaces and requirements related to plans offered through the Marketplaces
- Defining the "essential health benefits" (EHB) that must be covered by insurers both inside and outside of the Marketplaces
- Providing assistance for education of midwives
Available Literature and Resources
- In January of 2015, ACNM joined an amicus brief in King v. Burwell case before the Supreme Court.
- ACNM Comments to CMS on DRAFT 2016 Letter to Issuers in the Federally-Facilitated Marketplace, January 8, 2015
- ACNM Comments on the National Association of Insurance Commissioner's Revisions to their Model Act for Health Benefit Plan Network Access and Adequacy, January 7, 2015
- ACNM Comments on Proposed Rule Establishing Marketplace Benefit and Payment Parameters for CY 2016, December 17, 2014
- ACNM comments to the National Association of Insurance Commissioner on revisions to the NAIC's Managed Care Network Model Act, October 28, 2014.
- Ensuring Access to High Value Providers: ACNM Survey of Marketplace Insurers Regarding Coverage of Midwifery Services, September 2014
- ACNM Issue Brief - Update on Recent Supreme Court Decision Impacting Coverage of Contraception, July 29, 2014
- Recording of November 4, 2013 ACNM/HRSA Joint Webcast on the ACA and Midwifery
- ACNM Discussion of Coverage Requirements for Birth Centers under Medicaid and the Health Insurance Marketplaces (October 5, 2013)
- On October 20, 2014, ACNM submitted comments to the Department of Health and Human Services regarding a proposed regulation responding to the Supreme Court's decision in the Hobby Lobby case, which exempted closely held, for-profit organizations from complying with a requirement in the Affordable Care Act that insurance plans cover all FDA approved contraceptive items and services.
- On June 10, 2014, ACNM submitted comments to CMS regarding implementation of the provider non-discrimination language contained in the ACA (6/10/2014)
- On February 25, 2014, ACNM submitted comments to CMS regarding plan network adequacy determinations (2/25/14)
- On January 21, 2014, the Coalition for Quality Maternity Care (CQMC), led by ACNM, submitted a comment letter to CMS regarding proposed plans for a Quality Rating System to be used to evaluate health plans offered through the Health Insurance Marketplace.
- ACNM Response to Concerns over Provider Anti-Discrimination Language in the ACA (8/26/2013)
- ACNM Signs onto Letter Opposing Blunt Amendment. The Amendment would allow employers to refuse coverage for any service on religious or moral grounds.
- ACNM Signs onto Letter Urging Coverage of Contraceptives under the ACA (November 17, 2011)
- ACNM Summary of Key Provisions of the ACA
- Accountable Care Organizations (ACOs)
- Annual Wellness Visit
- Anti-Discrimination against Health Care Professionals
- Comparative Effectiveness Research (CER)
- Direct Access to OB/Gyn Professionals
- Education Reform for Nurses and Nurse Midwives
- Essential Health Benefits
- Healthy Behaviors and Public Health
- Home Visitation
- Independent Payment Advisory Board (IPAB)
- Individual Mandate
- Medicaid Coverage of Birth Center Services
- Medicare Reimbursement for Midwifery Services
- Nurse Managed Health Clinics
- Prevention and Wellness
- Support for Pregnant and Parenting Teens and Women