Company LOGO Building Blocks to Health Care Reform Sue Williamson July 29, 2009

Colorado Health Care Snapshot Source of Insurance Numbers in Thousands – Source: June 2007 Lewin Report

TEXT Colorado Health Care Snapshot Characteristics of the Uninsured  70% of the uninsured are in the workforce or are the dependent of a worker  32% of the uninsured have family incomes of $20,000 or less; 13% have family incomes of $75,000 or more.  40% of the uninsured are between the ages of 19 and 34; Almost 20% are children  57% of the uninsured are white  About $1.25 billion will be spent on Colorado’s uninsured in 2007 – The uninsured pay for about ½ of their care out of pocket. Source: 208 Commission Report – January 2008

The Colorado Promise  Basic health care should be available and accessible to all Coloradans.  High quality health care should be available and accessible regardless of geography.  Health care for the 180,000 uninsured children should be an immediate priority.  Health care should be affordable and financed in a cost-effective manner.  Medicaid must become more efficient and effective.  We should foster competition as a means to drive quality up and costs down.  We all must take personal responsibility for our own health.  Health care reform must be developed collaboratively.

Health Reform Research 208 Commission  2006 Bi-partisan Commission created  27 very diverse members  15 months, 31 proposals, 24 community meetings  Delivered recommendations to Legislature Jan. 31  Historic, important Community Forums  Fall of 2007 & 2008  Statewide outreach  2007: Focused on the vision for a stronger health care system and the values guiding that vision  2008: Update on progress, discussion of specific strategies

Delivering on the Promise 2007  Established Preferred Drug List for Medicaid  Launched Medical Home pilot program  Expanded mental health benefits in the small group private market  Invested in immunizations  Launched anti-obesity & rural health initiatives with private sector partners  Piloted important disease management programs 2008  Expanded CHP+ eligibility*  Provided Medical Homes for all Medicaid & CHP+ children  Began Eligibility Modernization  Increased Medicaid reimbursement rates*  Established CIVHC  Made Health IT investment through CORHIO  Required standard health plan ID cards  Established consumer resource website

2007 / 2008 Results  $4 million realized savings to Medicaid from the Preferred Drug List in the first year  149,000 Medicaid and CHP+ children enrolled in Medical Homes  Increases in all categories of primary care providers accepting Medicaid clients  Launched DOI consumer Web site  Promulgated regulations for standard ID cards  Hired Dori Biester as Interim Director of CIVHC and appointed board of high profile community leaders

Delivering on the Promise 2009: CO Healthcare Affordability Act  Historic legislation – largest health coverage expansion in 40 years  Cover more than 100,000 uninsured through Medicaid and CHP+ expansions  CHP+ to 250% for kids and pregnant women  Medicaid to 100% for parents and childless adults  Medicaid buy-in for working disabled  Reduce uncompensated care and cost shifting by increasing Medicaid reimbursement to hospitals  Financed through hospital provider fee – commonly used financing tool; 23 states using hospital fees

Delivering on the Promise  Strengthen and streamline loan forgiveness programs & establish Primary Care Office to help rural & underserved communities (HB 1111)  Ensure faster, easier transitions to long term care for Medicaid clients through presumptive eligibility (HB 1103)  Allow incentives in insurance for voluntary wellness programs (HB 1012)  Make it easier for families to navigate Medicaid and CHP+, by establishing electronic systems for re-enrollment (HB 1020)  Eliminate the arbitrary waiting period for legally present pregnant women and children to enroll in Medicaid and CHP+ (HB 1353)  Requires insurance coverage for the treatment of Autism (SB 244)

Outreach and Enrollment  Since January 2007  67,000 more children (27% increase) and 23,000 more adults enrolled in Medicaid and CHP+  Robust outreach activities  Advertising  Community outreach and training  Media relations  Marketing materials development and dissemination

Outreach and Enrollment  Novela (Spanish soap opera)  Targeted our Latino families (70% eligible, but not enrolled in our programs)  Twelve 30 minute episodes that emphasize family values and weaves primary health care converns into plot of the stories  Enrollment Fair Mini-Grant Program  $115,000 ($5,000 grants each) to 23 local CBOs yielded 700 new enrollments  Regional conferences and trainings

Pre-Implementation Funding and Technical Assistance Opportunities  Colorado has experienced strong local health foundation support  Funding from Colorado Trust allowed us to begin planning for implementation even before we knew what the policy solutions were going to be  SCI opportunity allowed us to meet with national experts and share information with other states as we began health care reform discussions