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Ask a Policy Wonk: "How Can I Get Ready for Health Care Reform?"

September 17, 2013

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Any other words of advice or resources you can recommend?

Mulhern-Pearson: Again, try to find a navigator or other benefits counselor who can help you understand your eligibility and guide you through the enrollment process. Covered California is training navigators -- what they're calling "certified enrollment entities"; you can request enrollment assistance online. In California and other states, you can also call your local HIV/AIDS organization for recommendations. Or ask your provider's office -- a lot of clinics are doing enrollment assistance and might have expertise to share with you.

It's also going to be up to consumers to educate themselves and make sure they are asking questions: "What about ADAP? What about OA-HIPP?" Bring a list of those questions with you when you meet with your benefits counselor.

Also, people who are newly married -- including some LGBT people who are now able to get married for the first time -- may want to talk with a tax specialist about how to calculate joint income. Especially if you qualify for tax credits, projecting income accurately will be important. It may be tempting to underestimate, because you'll get a higher assistance level, but be aware that you may get hit with a big bill at the end of the year. You really want to make sure you're making the best estimate possible for your projected income.


For medical and service providers, the San Francisco HIV Health Care Reform Task Force has prepared a "provider considerations" checklist of things providers and agencies can be thinking about as open enrollment approaches. The document can be edited to tailor it to other cities and regions, and we're working on a more generic version that is less specific to San Francisco. We are also currently working to develop a curriculum for benefits-counselor trainings; stay tuned for that. will be updated as open enrollment approaches and progresses. We're doing a webinar series that includes follow-up teleconferences with the presenters and open Q&A sessions about what people are experiencing around health reform in different states. The next webinar is this Friday, September 20, and the slides will be available online. is a great resource; it has become a repository for articles, facts sheets, slides from webinars, and other materials that individuals and providers can really make use of as they sort out the changes coming with health care reform.


Have questions about health care reform, open enrollment, and how to navigate the changes ahead? Use these resources to get up to speed and get the most from your evolving health coverage options.

  •  Webinars, videos, slide sets, articles, blog posts, and more make this collaborative site a terrific, comprehensive resource for individuals and providers alike.
  • Kaiser Family Foundation: Information and tools to help you understand health care reform in your region, including videos, fact sheets, state-by-state comparisons of health reform changes, and even a health insurance subsidy "calculator."
  • Connect with your state's health insurance marketplace, and learn about new health coverage options for yourself, your family, and (if you're a business owner) your employees.
  • AARP Health Law Answers: This interactive tool generates a "report" with basic info about your new health coverage options based on your state, age, income, and number of people living in your household.
  • Q&A for Ryan White Program Clients: From the San Francisco HIV Health Care Reform Task Force comes this downloadable, customizable FAQ document for providers to share with their clients.
  • HIV Medical Association: Health reform fact sheets and other resources specifically for HIV care providers and practitioners who treat underserved populations.
  • Applicable beyond the Bay Area, these resources from the San Francisco Department of Public Health are designed to support providers in navigating the transition to health care reform.

Reilly O'Neal is the editor of BETA.

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U.S. Health Care Reform

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