State health insurance exchanges explained

May 7, 2012

By Paul R. Pace, News staff

NASW has urged the U.S. Supreme Court to uphold the individual health mandate and Medicaid provisions outlined in the Affordable Care Act in two amicus briefs, coordinated by the Legal Defense Fund, so that quality health care is available and affordable for all.

A new NASW Practice Perspective, “State Health Insurance Exchanges: What Social Workers Need to Know,” provides insight into the role social workers can play in shaping their states’ health insurance exchanges and  what to anticipate from health care reform.

The U.S. Supreme Court is expected to rule on challenges to the ACA in June. In the meantime, states are required to follow the timetable set by the ACA and have health exchanges operating by Jan. 1, 2014.

A health exchange is a government-regulated marketplace of insurance plans, available at competitive rates to those without employer-sponsored health coverage and to small businesses. States are also required to develop a package of essential benefits that will be offered by health plans operating on the exchanges.

“It’s important to understand how health insurance exchanges will work, because every social worker will be touched by them in some way,” said Stacy Collins, an NASW senior practice associate who wrote the Practice Perspective.

She noted that regardless of what the U.S. Supreme Court rules, many states already see the value in establishing the exchanges. “Some states are going full speed ahead,” Collins said. “This is an opportunity for social workers to get involved.”

Many clinical social workers will be part of provider networks in the exchange plans.

“While states are crafting the specifics of their essential health benefits packages, social workers will want to ensure that mental health and substance-abuse services offer adequate duration, scope and reimbursement levels,” Collins said.

From the May 2012 NASW News. NASW members click here for the full story.