Year One of the Affordable Care Act
Mike Jawer, AANP Director of Government and Public Affairs
Tuesday, December 9, 2014
by: Mike Jawer, AANP Director of Government and Public Affairs

Section: State and Federal Advocacy

The first year of Affordable Care Act (ACA) is coming to a close and NDs have a lot to be proud of in the way we’ve organized and lobbied for insurance coverage consistent with Section 2706 of the law.

Over the past 18 months – going back to mid-2013 – AANP’s 2706 Team has met once a month, sharing information, experience, model documents, enthusiasm and exhortations, all in an effort to have insurers cover NDs consistent with the way they cover MDs and DOs…all of whom provide Essential Health Benefits as defined under the law.

Over that time, dozens of meetings have been arranged between state association leaders and insurers, on the one hand, and between association leaders and state insurance officials, on the other. These meetings have raised the understanding of what naturopathic medicine is and what NDs do. It’s been emphasized that NDs use the same CPT codes as MDs and DOs so that insurance companies can include NDs in existing plans with little effort or cost. The cost-effectiveness of naturopathic medicine has also been highlighted. All of this has raised the visibility of NDs and put their objectives front and center.

The results are encouraging. In Maine, NDs are now being credentialed by the state’s co-op, Maine Community Health Options. In Montana, NDs are being accepted into the state’s BlueCross BlueShield plan. In Arizona, Meritus Health Plan and Cigna include NDs as in-network physicians and, in Hawaii, University Health Alliance has done the same. In other licensed states, NDs are covered out-of-network or are considered specialists – so a good deal of progress still needs to be made.

At the Federal level, AANP has argued strongly that the Department of Health and Human Services should issue guidance clearly reinforcing Congress’ intent in developing Section 2706 – namely, prohibiting insurers from excluding any category of licensed health care providers who are acting within the scope of their license or certification under applicable State law from in-network participation. Two federal health plans – FedBlue and GEHA – appear to be covering NDs consistent with Section 2706.

Not just NDs but the patients of NDs are getting into the act. Over the past year, thousands of emails and postcards have been delivered to governors and insurance commissioners by patients who want to make sure this part of ACA is being followed. The “CoverMyND” website has helped to mobilize this response – and, in the wake of the November elections, more state associations are reaching out to patients to generate a groundswell of postcards. AANP is also working with the Integrative Health Policy Consortium, a national alliance of integrative medicine professionals, to advance Section 2706. Check out their “CoverMyCare” facebook page – and “like” it to register your support for this grassroots effort.

Looking back over 2015, you can be proud of what your state associations and AANP have accomplished. Insurance companies and insurance commissioners are now well aware of NDs and naturopathic medicine, and they’ve heard from scores of doctors and patients. We’re on record with state and federal authorities, and continuing to press the point that the law is the law and needs to be followed. Our 2706 Team, the brainchild of Lorilee Schoenbeck, ND, has carried this message forward. Expect inroads to continue to be made next year – year two of the Affordable Care Act.
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