Your Source for Health Reform

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Many questions about how health reform is affecting us have already been answered. Perhaps yours is one of them. If you do not find the answer you need below, please send us your own question.


YOUR QUESTIONS ANSWERED

 Q:   Do insurance companies have to contract with FQHCs (Federally Qualified Health Centers) in the Health Insurance Marketplace?

 A:   Yes, the Affordable Care Act requires private insurers offering plans through the health insurance exchange to contract with health centers. The health law also includes a provision that mandates full participation by safety net providers in Exchange plans, requiring Exchange plans to contract with all safety net providers. Safety net providers include all FQHCs and other entities that serve predominately low-income, medically underserved individuals. This requirement ensures that as uninsured patients gain coverage through the new insurance Exchanges, and that the plans covering them will not exclude those most in need of access to care. For more information click here.

 Q:   What options are available to immigrants both undocumented and with legal documentation to purchase health insurance in 2014?

 A:   The ability to purchase health insurance in the exchange will be limited to U.S. citizens and legal immigrants (who are not incarcerated.) Undocumented immigrants will not be allowed to purchase insurance (even at full cost with no government subsidy) in the exchange nor will they be eligible for premium tax credits or cost-sharing reductions. Due to these restrictions, however, they will also be exempted from the "individual mandate" requiring the purchase of health insurance. Undocumented immigrants are not eligible for Medicare, non-emergency Medicaid or CHIP, but remain eligible for emergency care under federal law. One exception is for children who are eligible for All Kids, regardless of immigration status, as long they are residents of Illinois; are age 18 or younger; and they meet the income and insurance requirements. For more information relating to immigrants, go to our immigrant info page by clicking here.

 Q:   Where do low income patients receive care?

 A:   Federally Qualified Health Centers and other safety net clinics play an important role in the delivery of health care in 2014. Patients will rely on their community providers for primary care and may choose a clinic as their medical home. Most Medicaid patients will be or are in some sort of coordinated care either managed care through an insurer, or an innovations project under a provider group. This means that clinics need to plan ahead to ensure that they are part of the delivery system choices for their patients. More low income patients are enrolled in Medicaid and in the new health care exchange, and clinics can serve as a medical home for these patients and receive reimbursement. See Get Covered Illinois' FAQs about using new coverage here.
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