Understanding the Health Insurance Marketplace: A Tool Kit for Nursing Faculty
This tool kit was created for AACN faculty members to enhance their understanding of the Health Insurance Marketplace and what it means for nurse educators, students, and patients. The resources below were designed for faculty and student use. To suggest additional resources for this page, please contact Leeza Constantoulakis, AACN’s Government Affairs Assistant at LConstantoulakis@aacn.nche.edu.
The American Association of Colleges of Nursing (AACN) is a nonpartisan organization that serves to educate and advocate for sound policy that improves nursing education, research, and practice. AACN views federal advocacy as having an integral role in the ability to shape, advance, and promote a professional nursing workforce that meets America’s healthcare needs.
While AACN did not take an official position on the Patient Protection and Affordable Care Act [Public Law No: 111-148], the organization supported a number of provisions that improved nursing education, research, and practice. AACN’s leadership recognizes the responsibility to educate our constituents about the law and what the Marketplace means for clinical practice, faculty, students, and patients. To review these provisions, www.aacn.nche.edu/government-affairs/HCRsupport.pdf.
Open Enrollment: 2015
Open Enrollment for 2015 begins on November 15th and ends February 15th, 2015. Beginning in 2015, open enrollment periods will be 2 months long.
The 2015 open enrollment period will mirror that of the traditional health insurance market as much as possible. Therefore, the emphasis will be on allowing Marketplace consumers to auto-enroll in the same plan for 2015. While this should simplify the renewal process for many, consumers are still encouraged to use the enrollment period to review and update their information in the Federally-facilitated Marketplace. Those who are reevaluating their coverage needs may still visit the Marketplace to shop and compare plans.
Consumers receiving the Advanced Premium Tax Credit (APTC) should log into the system and update their information for 2015 during the open enrollment period. Those who do not take action will not be automatically dropped from the program, however. Consumers whose tax data indicates they are likely still eligible will be auto-enrolled in their same plan for 2015 with their APTC unchanged from 2014. Efforts will be made to reach out to those who did not allow access to their tax data in the system or whose tax data indicates there may be a change in eligibility to ensure updated information. For additional details, see: http://www.hhs.gov/news/press/2014pres/06/20140626a.html.
Resources for the Newly insured
CMS Launches “From Coverage to Care” Initiative for Patients and Providers
On June 16th, 2014 the Centers for Medicare and Medicaid Services (CMS) launched its Coverage to Care “C2C” Initiative. This initiative is designed to provide guidance to newly-insured patients about the benefits of their new coverage, with an emphasis on accessing primary and preventative service. In addition, it serves as an educational tool for practicing providers to assist their patients as they navigate their insurance benefits. The C2C website includes several resources for patients to learn more about how to use their coverage, as well as for providers to use to discuss these topics with their patients.
Now that the Marketplace Has Closed, What are the Exceptions for Coverage and the New Enrollment Period?
The US Department of Health and Human Services designed the Health Insurance Marketplace to allow individuals and small businesses to compare health plans, find answers to questions about health care, and to show potential tax credits for health care. As of April 1, 2014, over 7 million Americans signed up for affordable care through the Marketplace during the Affordable Care Act's open enrollment. Although the deadline for 2014 passed on March 31st for 2014, special exceptions may apply to extend the eligibility for signing up for 2014. These include: getting married; having, adopting, or placement of a child; permanently moving to a new area that offers different health plan options; turning 27 years of age (no longer covered by parental health insurance); or losing other health coverage. For more information on special enrollments, click here.
resources for faculty
Assisting Your Patients: Navigating the Health Insurance Marketplace
This slide deck was created for faculty and students to understand the basics of the Health Insurance Marketplace. It provides an overview of key questions nurses may be asked by their patients and how to direct them to the best resources.
Teaching Nursing Students About the Health Insurance Marketplace: Example Activities and Assignments
This slide deck offers faculty suggestions on assignments, discussion questions, and activities that could help nursing students better understand the Marketplace.
What's Your Question for President Obama
On March 14, 2014 President Obama is sitting down for his first-ever interview with WebMD -- a leading online source of health care information, for both families and health care professionals. He's discussing the importance of getting covered under the Affordable Care Act, and he's taking your questions.
Implementation of the ACA: What Nurses Need to Know
As the nation works to implement the ACA, the current healthcare delivery system will undergo many complex changes. Mandy Cohen, MD, MPH, Senior Advisor to the Administrator of the Centers for Medicare and Medicaid Services (CMS), addresses the expansion of insurance coverage with the initial launch of the new Health Insurance Marketplace and answers questions on these timely topics. Ellen Marie Whelan, PhD, RN, FAAN, Senior Advisor for the Innovation Center at the Centers for Medicare & Medicaid Services, discusses the impact of the ACA on nursing practice and offers some guidance for nurses as to how best to prepare for the transition. To view the recording: Login to AACN’s Collaboration Community.
Lay of the Land: Healthcare Policy’s Political Landscape in 2014
This webinar provides an overview of the political landscape shaping healthcare policy in 2014. Julie Shroyer, MSW, Senior Policy Advisor for Polsinelli, a healthcare policy firm in Washington, DC, discusses how Congress and the Administration influence legislation that drives our nation’s healthcare delivery system. Also addresses during the Webinar is the role of committees of jurisdiction, nursing champions in the House of Representatives and the Senate, and federal agencies. In addition, Ms. Shroyer explains how the current budget environment, implementation of the ACA, and the upcoming Fall 2014 election cycle may impact nursing and health care. To view the recording: Login to AACN’s Collaboration Community.
Nurses Matter: National Nursing Call
On January, 23, 2014, U.S. Department of Health and Human Services Secretary Kathleen Sebelius and Mary K. Wakefield, PhD, RN, Administrator of the Health Resources and Services Administration (HRSA), briefed over 500 nurses on the importance of their role in educating the public on the Health Insurance Marketplace. AACN invited our members to attend this discussion. For more information see, www.hrsa.gov/affordablecareact/nursesmatter.html.
A Message from HRSA Administrator Wakefield on the Marketplace Enrollment
On February 24, 2014, HRSA Administration Mary Wakefield, PhD, RN, offered a message to the healthcare community on enrollment in the Marketplace.
Get Covered: A Special Message from the President
Interested in learning the Administration’s progress since the Health Insurance Marketplace? Listen to President Obama’s most recent address from February 21, 2014.
Kaiser Family Foundation Presents: The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act
Watch this video to understand the basics on the Health Insurance Marketplace. Many faculty have used this video to spark online discussions with their students.
Where Can I Find Out More Information about the ACA?
Basic Information about the Affordable Care Act
- HHS.gov/HealthCare: How the Health Care Law Benefits You
- Kaiser Permanente: Understanding the Affordable Care Act
- U.S. Department of Health and Human Services The Partnership Center
- U.S. Department of Health and Humans Services: The Health Care Law and You
Additional Information on Marketplace Enrollment
Medscape - New Resources for Healthcare Providers
Note: Medscape Login Required
- Essential Health Benefits and the Marketplace: Information for Providers and Their Patients
- Talking with Patients about the Affordable Care Act: Protecting Access to Care for Serious Illness
Information for College Students
Information for Young Adults
- HHS.gov/HealthCare: State by State
- National Conference of State Legislators: State Actions to Address Health Insurance Exchanges
- PhRMA and Avalere Health Fact Sheets on State Exchanges
Strategic guidance and review of the Toolkit’s outline was provided by AACN’s inaugural class of Faculty Policy Intensive Fellows (2013-2014), including:
Patricia Brennan PhD, RN, MS, DPNAP
Samuel Merritt University
Melondie Carter, DSN, RN
University of Alabama
Mary Garnica, DNP, APNFNP-BC
Assistant Professor of Nursing
University of Central Arkansas
Joanne Noone, PhD, RN, CNE
Associate Professor, Associate Dean, Ashland Campus
Oregon Health & Science University
Camille Burnett, PhD, MPA, RN, APHN-BC, BScN, DSW
Assistant Professor and Roberts Scholar
Department of Family, Community and Mental Health Systems
University of Virginia School of Nursing
Lilia A. Fuentes, DNP, APRN, FNP-BC
Assistant Professor – Department of Nursing
Master of Science in Nursing Program Coordinator
The University of Texas – Pan American
Sharon Guthrie, PhD, ARNP, CPNP, NCSN, RN-BC
Mount Mercy University
Andrea Sonenberg, PhD, WHNP, CNM