The New Health Care Law and You

Two thirds of the uninsured live in 13 states 3 Uninsured by State <230K230K - 600K 600K - 1.1M 1.1M+ Number of Uninsured 67% of uninsured live in 13 states Source: Census Bureau, Current Population Survey, March 2011 and 2012

One fifth of the uninsured live in the top 13 counties and half live in the top 114 counties 4 Uninsured by County 10% of the uninsured live in just 4 counties (LA, Harris, Cook, Miami) 20% of the uninsured live in top 13 counties (Top 4 + Next 9) 50% live in the top 114 counties (3.8% of total counties in the US)

Need to Inform, Educate and Assist with Enrollment 5/19/2015The Health Insurance Marketplace 1015

Looking at the Model by Zip Code (Source: Enroll America)

 A new way to get health insurance Enrollment starts October 1, 2013 Coverage begins January 2014  About 25 million Americans will have access to quality health insurance Up to 20 million may qualify for help to make it more affordable Working families can get help through the Marketplace The Health Insurance Marketplace 5/19/2015The Health Insurance Marketplace 1017

All Qualified Health Plans Will Cover These Essential Health Benefits 5/19/2015The Health Insurance Marketplace Prescription drugs 7.Rehabilitative and habilitative services and devices 8.Laboratory services 9.Preventive and wellness services and chronic disease management 10.Pediatric services, including oral and vision care 1.Ambulatory patient services 2.Emergency services 3.Hospitalization 4.Maternity and newborn care 5.Mental health and substance use disorder services, including behavioral health treatment

 Cancer screenings such as mammograms & colonoscopies  Vaccinations such as flu, mumps & measles  Blood pressure screening  Cholesterol screening  Tobacco cessation counseling and interventions  Birth control  Depression screening  And more… Visit for a full list. The Law Makes Health Insurance More Affordable In many cases, you can get preventive services for free:

 Marketplace initial open enrollment period starts October 1, 2013 and ends March 31, 2014  Marketplace eligibility requires consumers to Live in its service area, and Be a U.S. citizen or national, or Be a non-citizen who is lawfully present in the U.S. for the entire period for which enrollment is sought Not be incarcerated Eligibility and Enrollment 5/19/2015The Health Insurance Marketplace 10110

Submit single, streamlined application to the Marketplace Verify and determine eligibility 5/19/2015The Health Insurance Marketplace Application and Eligibility Online Phone Mail In Person Supported by Data Services Hub Eligible for Marketplace or Medicaid/CHIP Enroll (Marketplace) Screen (Medicaid/CHIP)

 Help will be available in the Marketplace Toll-free call center - 24/7Federal Call Center is up and running and the number is:  150 languages Website chat 24/7 (English and Spanish) Help in-person  Navigators  Other trained enrollment assisters  Local Community Health Centers, libraries, hospitals and other locations in local communities  Agents and brokers Assistance – It’s Available If You Need It 5/19/2015The Health Insurance Marketplace 10112

 Based on family income and size Premium discount  Family of four with annual income $23,550* – $94,200* or less  And not eligible for certain other insurance coverage l ike Medicaid Lower cost-sharing (like copays)  Family of 4 with annual income $58,875* or less (some other restrictions) *2013 amounts Help to Pay Qualified Health Plan Costs 5/19/2015The Health Insurance Marketplace 10113

5/19/2015The Health Insurance Marketplace Starting October 1, 2013, you will be able to apply through this site Now - Sign up for and Text Alerts and Get Ready

Marketplace.cms.gov 5/19/2015The Health Insurance Marketplace Get the latest resources to help people apply, enroll, and get coverage in 2014

Arizona Provider Website

ACA Requirements for States Technology changes Eligibility determination methods Medicaid changes 1/1/14 Provide access to the Federally Facilitated Marketplace 10/01/13

Health -e- Arizona AHCCCS’ ACE DES’ AZTECS New Application and Eligibility System Health-e-Arizona Plus

Between Arizona and the Federally Facilitated Marketplace, Consumers Have a Wide Range of Program Options Full Range of AHCCCS Benefits AHCCCS Health Insurance (Medicaid) ALTCS Freedom to Work (FTW) Breast and Cervical Cancer Treatment Program (BCCTP) Medicare Savings Programs (MSP) Other Federal and Local Programs Nutrition Assistance (SNAP or Food Stamps) Temporary Assistance for Needy Families (TANF) Clinic-based Sliding Fee Scale programs SFS) County-based Community Assistance Programs (CAP) Exchange Programs Premium Tax Credit Program Cost Sharing Reduction Program Private Insurance, No Subsidy Small Business Health Opportunities Program (SHOP) for employers of 50 employees or less

SNAPTANFClinic SFS County CAP AHCCCS & KidsCare PTCCSR Private Insurance (No Subsidy) SHOP Many Programs are Accessed Through Health-e-Arizona Plus FFMHealth-e-Arizona Plus SNAP = Supplemental Nutrition Assistance Program (Nutrition Assistance) TANF = Temporary Assistance for Needy Families (Cash Assistance) Clinic SFS = Clinic-based Sliding Fee Scale programs County CAP = County-based Community Assistance Programs (CAP)(Pima and Santa Cruz Counties) PTC = Premium Tax Credit Program CSR= Cost Sharing Reduction Program SHOP = Small Business Health Opportunities Program Link to FFM Start Here Apply for Referral to FFM

SNAPTANFClinic SFS County CAP AHCCCS & KidsCare PTCCSR Private Insurance (No Subsidy) SHOP Applications Started at the FFM FFM Health-e-Arizona Plus SNAP = Supplemental Nutrition Assistance Program (Nutrition Assistance) TANF = Temporary Assistance for Needy Families (Cash Assistance) Clinic SFS = Clinic-based Sliding Fee Scale programs County CAP = County-based Community Assistance Programs (CAP)(Pima and Santa Cruz Counties) PTC = Premium Tax Credit Program CSR= Cost Sharing Reduction Program SHOP = Small Business Health Opportunities Program Start Here No AccessApply forAssessment

Integration with FFM Arizona Federally Facilitated Marketplace

Arizona Wants to Avoid Consumer Confusion ? HEAplus Federally Facilitated Marketplace ? ?

Upcoming Milestones 09/01/13 Consumer Support Line 10/01/13 Health-e-Arizona Plus and Health Insurance Marketplace go live QHP open enrollment begins 01/01/14 Medicaid changes are effective QHP enrollment is effective

What is the MIHS Plan?  Focus on Micro-targeting  Collaborate with VISTA and AmeriCorp Volunteers  Develop Matrix of Leads within Clinics or Areas of the Hospital  Create and/or Distribute Informational Materials  Created  Created SharedGroup Folder: ACA 26

What is the MIHS Plan?  Training staff on how to help customers by: Identify those who will benefit Inform them of the programs (Medicaid Expansion and Marketplace) Educate patient (Family Learning Centers) Refer patients (Consumer Assisters, Brokers, Agents and Navigators) Enroll (HEA Plus or FFM)  Explore scheduling enrollment events 5/19/2015The Health Insurance Marketplace 10127

For More Information 1. Contact your Medical Provider or Case Manager 2. Visit Visit 3. Health Insurance Marketplace Toll-free Call Center Available 24/ TTY: Contact our Family Learning Center Staff at MIHS at 28

Acknowledgements This presentation is a compilation of many sources including:  Center for Medicare and Medicaid Services, The Health Insurance Marketplace (July 2013)  Census Bureau, Current Population Survey, (March 2011 and 2012)  Enroll America  Kaiser Family Foundation, Tracking Poll (April 2013)  Arizona Health Care Cost Containment System Administration (May 2013)  Arizona Alliance for Community Health Centers (July 2013) 5/19/