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Marketplace Health Plan Assessment Tool for Persons Living with HIV/AIDS

As a result of the Affordable Care Act (ACA), enrollment in marketplace health insurance plans began October 1, 2013. The Center for Health Law and Policy Innovation (CHLPI) of Harvard Law School has designed a Marketplace Health Plan Assessment Tool to help assess which plans are suitable for low-income persons, homeless persons, and persons living with chronic illnesses including HIV/AIDS and mental illness. The tool, which includes a workbook and worksheet, is designed to do the following:
  • Evaluate local insurance plans for affordability and key provisions that will have the biggest impact on access to care and treatment.
  • Build capacity among advocates and case managers to assist clients and monitor new plans to ensure adequacy for all consumers, especially those with more significant healthcare needs.
For more information on the tool, visit the Marketplace Health Plan Assessment Tool page on the HIV Health Reform website.
  • Every state has a Health Insurance Marketplace that functions as a portal to health coverage. 
  • Some states have elected to operate their own Marketplace, others to be served by a Marketplace operated by the federal government, and still others to share some responsibilities in partnership with the federal Marketplace.  
  • The Marketplaces are intended to facilitate access to affordable healthcare coverage for people with incomes below 400% of the federal poverty level (FPL) in every state (even in those that have elected not to expand Medicaid coverage to people with incomes below 138% of the FPL).  
  • In addition, in all states people who are currently eligible for the legacy Medicaid program can be identified and referred for Medicaid enrollment by the Marketplace, without regard to the states’ decisions about Medicaid coverage expansion.
  • The federal government is funding specialized outreach and enrollment assistance in every state.
*Because of possible new insurance options, and the increase in access to enrollment for many clients, it is essential that housing and services providers use the information available on websites such as www.enrollmentamerica.org to familiarize themselves with the Health Marketplace options in their state, and develop a plan to assist their constituents to obtain Medicaid or affordable health insurance coverage.

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