Advancing Sovereignty Tribal Sponsorship under Affordable Care Act (ACA) Presentation at TSGAC – ANHB ACA Self-Governance Training April 6, 2016.

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Presentation transcript:

Advancing Sovereignty Tribal Sponsorship under Affordable Care Act (ACA) Presentation at TSGAC – ANHB ACA Self-Governance Training April 6, 2016

Is full funding of (acute care) health services within reach for Tribes and Tribal citizens?

Insurance Status and Distribution of Uninsured Active Users: Alaska 3

Hypothetical Example of Pre-Sponsorship Insurance Coverage and Funding 4

DST - SGT Joint Initiative on Sponsorship In May 2015, the first joint meeting of the Tribal Self-Governance Advisory Committee to IHS and the Direct Service Tribes Advisory Committee took place One initiative generated was the “DST-SGT Joint Initiative on Sponsorship” – Goal of Joint Initiative is to ensure that each Tribe, no matter where on the direct service – self-governance spectrum, is able to use a portion of the congressional IHS appropriation for the Tribe for the purpose of Sponsorship of Tribal members – Tribes have authority whether to conduct Sponsorship of Tribal members or not DSTs, SGTs and IHS are working towards creating a set of tools to facilitate Sponsorship, including— – IHS / Tribe contract and report templates for establishing Sponsorship by Tribes – Agreement with IHS that a portion of funds currently managed by IHS can be transferred to Tribe to conduct Sponsorship Or Tribe can use appropriations and 3 rd party revenues the Tribe is managing – Series of analyses being conducted to evaluate Sponsorship options, costs and net impact on health service resources 5

Insurance Status and Distribution of Uninsured Active Users: Sample IHS Area 6

Case Study #10: Analysis of Tribal Sponsorship Options 7

Sponsorship Costs versus Increased Health Service Resources 8

Net Gain in Health Resources 9

Illustration of Impact of Sponsorship through Marketplace: Insurance Coverage and Funding 10

11 SOURCE: TSGAC analysis of Federally-Facilitated Marketplace, Anchorage, Alaska, 2016.

12 SOURCE: TSGAC analysis of Federally-Facilitated Marketplace, Anchorage, Alaska, 2016.

13 SOURCE: TSGAC analysis of Federally-Facilitated Marketplace, Anchorage, Alaska, 2016.

14 SOURCE: TSGAC analysis of Federally-Facilitated Marketplace, Anchorage, Alaska, 2016.

Average Returns for Average Risk Enrollees: Marketplace Coverage, Alaska,

Illustration of National AI/AN Enrollment in Bronze-Level Plans 16

Illustration of National AI/AN enrollment in bronze-level plans: premiums, cost-sharing, and average health care expenditures 17

Timing of T-SHIP Enrollment 18

Uninsured Alaska Natives and American Indians, by T-SHIP Participating THO Operating Area 19

Extrapolated Income Distribution of Uninsured Alaska Natives and American Indians, by T-SHIP Participating THO Operating Area 20

Full State-wide Tribal Sponsorship of Uninsured Alaska Natives and American Indians 21