S.C. Alliance of Health Plans SCAHU Annual Symposium March 24, 2015

What is the SCAHP? For over 20 years the South Carolina Alliance of Health Plans has been the state’s leading voice for market driven innovation and solutions to health care challenges.

Legislative advocacy on health plan related issues Works with state regulatory agencies to develop transparent and effective regulatory frameworks for public health care (Medicaid) commercial health plans Educates the media, consumers and employers about health care quality, provider accountability and affordability Engages the community on disease management and education

SCAHP & SCAHU Partnership Legislative and Regulatory Advocacy Grassroots Mobilization Coalition Building and Collaborating to Lead Industry Educating Policymakers, Consumers and the Media

What do Americans want from Government today?

National Poll: Spend more, tax less, legalize pot Source:

Legislative Advocacy

H.3020 (Chumley) and S.103(Bright) – Freedom of Choice in Health Care Act/Navigator Background Checks S.135 (Cleary) Ryan’s Law – Autism Mandate Expansion S. 314 (Campsen) – Healthcare Sharing Ministries 2015 Legislative Session

H.3144 (Ryhal) – Navigator Background Check Act H.3252 (Stavrinakis) – Election of the Director of the SCDOI H.3490 (Quinn) – Business License Tax Reform Act 2015 Legislative Session

H.3022 (Chumley) – Prohibit Recognition & Benefits to Same-sex Marriage Persons H.3448 (Hardee) – Air Ambulance Affordable Act H.3726 (Mack) – Palmetto Comprehensive Health Care Act 2015 Legislative Session

DOI Regulatory Control Consumer Protection Services Navigators Ever Changing Enforcement Rules Current ACA Subsidy Litigation, King v. Burwell

“… Exchange established by the State.”

SC Enrollment Numbers as of March 2, ,855 individual have enrolled in the FFE They represent 77.88% of the 223,237 individuals that have enrolled in a 2015 Qualified Health Plan (QHP) for individual market coverage on the FFE. This includes automatic renewals for qualifying individuals that had a 2014 plan through one of the FFE carriers. Current South Carolina ACA Data

90.7% are receiving a federal subsidy, which means they are between 100% and 400% of the Federal Poverty Level 62.08% are receiving both federal subsidies, which means they are between 100% and 250% of the Federal Poverty Level The average age is years old (compared to years old for the 28,024 individuals that have coverage through a 2015 Plan sold outside the FFE from one of these same five carriers) Current South Carolina ACA Data

Uninsured Choose Penalty, Pass Up Enrollment Offer Individuals are choosing to pay fine vs. pay for coverage. 31% of the people surveyed said that “That they don’t need health insurance and the penalty is less expensive than coverage” Ex: 59 year old male in Florida $250 fine vs. $400 in monthly premium and $6,000 deductible. 41% of uninsured are unaware of the penalty for not having insurance. Obama Administration sent out 820,000 incorrect tax statements about 2014 health care coverage. This is causing consumers to wait to file returns or file amendments to their returns. Source: The Wall Street Journal

Current National ACA Data

Meetings with Director and key staff to address industry issues Navigators and Agent issues Post King v. Burwell planning

Quarterly Meetings with speaking opportunities SCAHP Annual Health Care Conference SCAHP Foundation

Thank You! Jim Ritchie Executive Director SC Alliance of Health Plans