+ Countdown to Coverage: The Affordable Care Act in IL June 7, 2013
+ About IMCHC Our Projects and Initiatives: Campaign to Save Our Mothers and Babies Chicago Area Immunization Campaign Cooking Matters Illinois Coalition for School Health Centers www.ilmaternal.org/hcr Illinois Premature Infant Health Network @ILMaternal Health Reform Education and Implementation kwaligora@ilmaternal.org Text4baby
+Agenda Improving health today 1. Transformative changes in 2. 2014 Pathways to coverage in 3. 2014 Connecting Communities 4. Resources 5. Download a copy of today’s presentation at http://ilmaternal.org/hcr/acapresentations.html
+ Improving Health TODAY Affordability & Accessibility Industry Reform Young people can stay on their No pre-existing condition parents insurance until they are exclusion for children 26 No lifetime limits on care and phasing out of annual limits Preventative and wellness No insurance recessions services without cost sharing except in cases of Including immunizations, fraud/intentional cancer screening, smoking misrepresentation cessation and a host of women Protecting consumers from specific provisions unreasonable premiums Tax credits to help small businesses offer coverage Closing Medicaid Part D donut hole
January 1, 2014 +
+ Transformative Changes Coming in 2014 Guaranteed issue protects those with pre-existing conditions Insurance companies cannot use health status to make any decisions—no denials, cannot charge higher premiums Gender rating eliminated Makes care more accessible and affordable for women Essential Health Benefits Ensure comprehensive coverage for ALL Includes coverage for mental/behavioral health, maternity and newborn coverage, and preventive/wellness services
+ Pathways to Affordable Coverage in 2014 Marketplace Tax Credits Medicaid and Subsidies
+ Tax Credits and Subsidies Tax Credits—Discounts on Premiums You can qualify for an upfront discount, in the form of a tax credit… …if you earn between $11,505 to Marketplace $46,021 for an individual or between $23,425 to $93,700 for a family of four AND don’t have affordable coverage from your employer Tax Subsidies for out-of pocket expenses Credits If you earn less that $34,516 for an Medicaid individual or $70,275 for a family and of four and purchase your policy Subsidies on the marketplace you can also get subsidies to lower out-of- pocket costs Tax credits and subsides available to US citizens and lawfully present immigrants
+ Medicaid Expansion The ACA expands Medicaid to cover all people under 138% of the federal poverty level Eliminates categorical eligibility which currently Marketplace creates a huge gap in coverage More than 618,000 could be eligible in IL! Tax Must be US Citizen or Legal Credits Permanent Resident of 5 Medicaid years or more to qualify and Subsidies 100% federally funded in the first three years, gradually reduces to 90% by 2020 Authorized by SB26 in IL
+ Health Insurance Marketplace Begin enrolling Oct 2013; benefits available January 1, 2014. Enroll in public and private health insurance, as well as access tax credits and subsides using a Marketplace single streamlined application Exchanges are only allowed to offer high-quality, qualified health plans that meet provider network standards, and offer at least an essential benefits package. Tax Give consumers the tools and power to have Credits control over their insurance decisions Medicaid and Apples-to-Apples comparison of plans Subsidies Organize based on cost, benefits, quality, and other features that matter to you Marketplaces will be available to US citizens and lawfully residing immigrants for subsidized or unsubsidized coverage (Undocumented immigrants completely barred from accessing)
+ How will the “mandate” affect you? The individual mandate requires most Americans to purchase health insurance starting January 1, 2014 or pay a tax if they do not comply You are exempt from the mandate tax if: You would have to spend more than 9.5% of your household income on the cheapest qualifying health insurance plan even after tax credits and subsidies Your income falls below the threshold for filing federal income tax You are undocumented or not a lawfully permanent resident You already meet this requirement if: You have insurance through your employer or purchase individual insurance on your own. You have insurance through Medicaid, Medicare, CHIP, Veteran’s Administration and/or Tricare for active duty and retire military, Indian Health Services Why do we need a mandate? Requiring so much of health insurance companies without requiring people to buy insurance would drive the cost of coverage to even less affordable levels Insurance is meant to be purchased BEFORE you need it. Waiting to buy health insurance would be like…..
+
+ Impact on Small Business Support to provide coverage for employees via tax credits Access to tools and resources made available by Marketplace, with SHOP Marketplace offering more choices in 2015 Businesses with less than 50 employees do not need to do anything differently! Security for entrepreneurs who can purchase affordable, high quality health insurance on the individual Marketplace
+ Connecting Communities
+ Impact on the Uninsured In Lake County 71,535 adults are uninsured (17% of the population). In 2014, the majority of these adults will have new access to affordable coverage in one of three ways. 50,000 40,000 39,040 30,000 26,975 20,000 21,339 10,000 10,521 0 New Medicaid Marketplace with subsidy Marketplace without subsidy Undocumented Source: Illinoishealthmatters.org, Visualizing Health Reform tool
+ Majority say they don’t know how ACA will impact them Do you feel you have enough information about the health reform law to understand how it will impact you personally, or not? Yes, have enough information No, do not have enough information Total 41% 57% Household income 30% 68% less than $40,000 Uninsured (under 33% 67% age 65) NOTE: Don’t know/Refused answers not shown. SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
+ In Person Assistance • Federally funded ($2.3 million in IL) • Duties: Outreach, Facilitate Enrollment, Provide Ongoing Navigators Support • Who: Cannot be a health insurance provider or someone paid by an health insurance provider to enroll individuals In Person • State funded (just over $28 million in IL) • Duties: Outreach, Facilitate Enrollment, Provide Ongoing Counselors Support • Who: Cannot be a health insurance provider or someone (IPCs) paid by an health insurance provider to enroll individuals Certified • Volunteers—no funding Application • Will participate in same training as Navigators and IPA’s but will go through the same training to provide application Counselors assistance (CACs) • Who: Anyone!
+ There is a role for everyone in outreach! Apply to be a Navigator/IPC/CAC Listen to our recorded webinar on outreach at ilmaternal.org/webinars Listen to IMCHC’s monthly webinars to learn more about the law www.ilmaternal.org/webinars.html Initiate conversations with clients when appropriate Create a culture of coverage by leading with this statement: “You have affordable coverage options available” Share educational resources Connect clients with in person assisters when possible Share feedback with IMCHC! Success stories: http://www.ilmaternal.org/mystory.html Experiences using new systems Best practices in outreach and enrollment Participate in IMCHC summer/fall trainings
+ Core Messages Create a culture of coverage: You have affordable coverage available to you! Get buy in using one of these messages, each of which is shown to resonate with 89% of the population! All insurance plans have to cover doctor visits, hospitalizations, maternity care, emergency room care, and prescriptions. If you have a pre-existing condition, insurance plans cannot deny you coverage You might be able to get financial help to pay for a health insurance plan. All insurance plans will have to show the costs and what is covered in simple language with no fine print.
+ Resources and Implementation Tracking IMCHC ACA Kaiser Family Foundation http://healthreform.kff.org/ http://www.ilmaternal.org/h cr National Women’s Law Center Illinois Health Matters http://www.nwlc.org/our- resources http://www.illinoishealthmat ters.org Health Insurance 101 Official HHS ACA site http://101.communitycatalys t.org/ http://www.healthcare.gov Enroll America Health Reform GPS http://www.enrollamerica.or http://www.healthreformgps g .org/
+ Questions? Kathy Waligora Health Reform Outreach Coordinator kwaligora@ilmaternal.org 312-491-8161 x29
Recommend
More recommend
