The June ruling by the U.S. Supreme Court in the case of King v. Burwell marked a significant victory for the Affordable Care Act – residents of states using the federal marketplace will continue to receive tax credits to help lower the cost of health insurance. Or to put it in human terms, more than 13 million Americans in 34 states will remain eligible for an average of $4,800 in tax credits annually per household.

However, other thorny issues lie ahead. Focus turns back now to Medicaid expansion, with a number of states such as Utah and Alaska announcing their intent to expand that program in the weeks since the court’s ruling. Despite that progress, many states still have opted not to adopt the Medicaid expansion allowed for under the ACA, and therefore many low-income residents of those states continue to find themselves without affordable health care options. SIS’s most recent ACA Spotlight illustrates the disparity in coverage options across states for households with different income levels, highlighting the reality that in some cases access to health coverage depends on where you live.

Looking ahead, federal agencies will be grappling with how much to charge the states that are using the federal marketplace, and are expected to propose new rules by the end of the year that will dictate how the states will have to pay to keep using healthcare.gov. They will also continue to make refinements to healthcare.gov and the ACA eligibility process in anticipation of the next open enrollment period in November.

Finally, the need for horizontal integration – facilitating access to programs beyond health care – continues. Improved access to health coverage is only the starting point to achieving the ACA’s larger goal of improving overall health status. As communities like Broward County, Florida have demonstrated, there is great need to connect people to a more comprehensive range of health and human services, such as access to food and housing, financial assistance, and child care. SIS will continue to push forward on many of these issues as we seek to optimize the implementation of the ACA and to address remaining needs.

Terri Shaw
SIS Director of Policy

Broward Common Eligibility Collaborative Leverages One-e-App

Recognizing that individuals struggling to put food on the table or to pay their rent are likely to be lacking other basic needs such as health care and child care, the Broward Common Eligibility Collaborative set out to identify a solution that would make it easier for people in need to identify and access the full complement of services for which they are eligible.  The Collaborative quickly identified and implemented One-e-App, and to date has connected more than 3,400 Broward County, Florida residents to needed health and human services using that solution. Read more

How does eligibility vary across states by family size and income?

SIS has released the second installment in its ACA Spotlight series, illustrating state variation in eligibility for insurance affordability programs (Medicaid, CHIP and subsidies for Qualified Health Plans purchased through exchanges).  Although the ACA was intended to provide affordable coverage options for all Americans with incomes below 400% of the poverty level, states have considerable flexibility to determine the income eligibility thresholds for two of the affordability programs – Medicaid and CHIP.  As a result the specific insurance affordability programs available to an individual or family depends on where they live.

SIS Expands Leadership Team

SIS welcomes three experienced executives to our leadership team to help drive application development and advance our current and future systems infrastructure.

• Stacey Savidge, Chief of Business Operations, will manage day-to-day operations at SIS and will oversee contract management and project accounting.  Stacey brings significant leadership experience to SIS, including delivery of IT application and infrastructure projects and directing performance and process improvements.  She has directed and delivered effective corporate IT infrastructures at HealthNet, Covered California, and Northrop Grumman.
• Cameron Tully-Smith, Director of Solutions, will be orchestrating the delivery of new and unique solutions across SIS beginning with One-e-App and related technologies.  He brings with him a wealth of technical expertise, and has more than 20 years of health care experience spanning payers, providers and vendors across organizations including Siemens, Oracle, Delta Dental, Sutter and the State of California’s Department of Health Care Services.
• Matt Townzen, Director of Product and Operations, will oversee the SIS Service Desk, formalize SLA reporting processes, and lead development of formal customer communications and forums for interaction.  Matt has two decades of experience delivering process and technology solutions and leading operations teams, most recently at Blue Shield of California where he spent eight years in various eBusiness and operational leadership positions.

Social Interest Solutions (SIS) is a national nonprofit organization dedicated to leveraging technology innovation to improve consumers’ access to public and private health and social services. As an active influencer and promoter of policy reform, SIS has successfully developed and deployed pioneering technology solutions that have positively impacted the quality of life for the nation’s underserved population.

In early 2003, Social Interest Solutions developed One-e-App, a Web-based system that streamlines the complicated eligibility and enrollment process by making it possible to transparently connect and share data across otherwise disparate federal and state health and social services systems and programs. Today One-e-App is deployed in Arizona, California, Florida, Indiana and Maryland and has served over 17 million individuals.

For more information on Social Interest Solutions, click here.