American College of Nurse-Midwives
8403 Colesville Rd. Ste. 1550 Silver Spring, MD 20910
Phone: 240.485.1800 Fax: 240.485.1818
All rights reserved
Implementation of the Affordable Care Act
Issue Summary
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
Government Resources
- Full Text of the Affordable Care Act
- Official government sites for consumers and providers.
- Congressional Budget Offices' Affordable Care Act site
- Comprehensive list of HHS Regulation and Guidance
- Guidance from the Health Resources and Services Administration on coverage of preventive and screening services for women
- Comprehensive list of IRS Regulations and Guidance
- White House summary of Women-Related Provisions of the ACA
Non-Governmental Resources
- English and Spanish flyers from the Young Invicibles, ACNM and ACOG regarding coverage options for new parents and babies.
- Tools to Understand and Access Breastfeeding Benefits under the ACA - National Women's Law Center
- Section-by-Section Summary of the Affordable Care Act prepared by Health Policy Alternatives
- Kaiser Family Foundation's Health Care Reform site
- Commonwealth Fund's Health Policy Reform site
- National Conference of State Legislatures' Health reform site
- National Academy of State Health Policy's ACA Implementation and State Health Reform site
ACNM Resources
- ACNM Comment Letter on Draft 2017 Letter to Issuers (January 17, 2016)
- ACNM Issue Brief on July 14, 2015 Final Rule Regarding Coverage for Contraceptive Items and Services (July 15, 2015)
- ACNM Comments to the Federal Trade Commission regarding provider network adequacy in the health insurance marketplaces (February 9, 2015).
- 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
- Executive Summary
- Slides for Discussion with Insurance Commissioners, December 15, 2014
- Talking Points for Discussion with Insurance Commissioners, December 15, 2014
- Form Letter to be Sent to Insurance Commissioners on Behalf of Affiliates, December 15, 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
Archives
- ACNM President Comments on Supreme Court Decision to Uphold the ACA (June 29, 2012)
- Coalition Letter Supporting Coverage of Contraception under ACA (November 17, 2011)
- ACNM Press Release responding to passage of the ACA (March 23, 2010)
- ACNM Efforts Leading up to Passage of the ACA (Materials through 2010)