Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources Our Mission: 1

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Health In Colorado 22% of adults obese; 14.2% kids 18.3% working age adults uninsured; 9.3% kids 20.7% of women receive initial prenatal care later than the first trimester or not at all 28.7% of preschool-age children do not receive all recommended doses of six key vaccines. 14.8% of adults reported having poor mental health

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Key Wins for Kids Public Coverage CHIP extended to 2019 Investments in home visitation and school based health centers Preventive services for children with no cost sharing – Screenings, immunizations, physical, oral, hearing, dev assessments Youth in foster care will be Medicaid eligible to age 26 Medicaid eligibility for parents – Studies have shown that gains in coverage for parents result in gains in coverage for children and that the health of the parent is a major determinant in the physical and mental health of the family Private Coverage No pre-existing condition exclusions or pricing based on health status Young adults can stay on their parents health insurance to age 26 No lifetime or annual limits Coverage of preventive health services at no cost Coverage expansion for parents through subsidies in the exchange

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Coverage Medicaid expansions up to 133% of poverty Premium tax credits available up to 400% of poverty Cost sharing subsidies up to 250% of poverty (limits out of pocket spending) Investments in workforce and clinic capacity Coverage

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Medicaid Expansion: The Right Choice for Colorado (SB13-200) Maximizing enhanced federal funding is the best option for Colorado o Allows provider fee dollars to stretch further with the enhanced federal matching funds o The Medicaid expansion is expected to have no impact on the state General Fund Expansion allows Medicaid to cover more than 160,000 additional Coloradans o Expansion allows us to cover more people with the right services at the right time and drive value in the system o 58,000 additional parents and adults likely to enroll between 100%-133% of FPL (138% with an automatic 5% income disregard) o In 2013, 133 percent of the FPL was $31,321 for a family of four and $15,282 for an individual o Supports Colorado’s health and economy by helping people stay healthier over the long term

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing What is the Colorado Health Benefit Exchange? An open, competitive marketplace soon to be called Connect for Health Colorado for individuals and small employers to: Compare information regarding cost and quality Shop health plan features containing the same base benefits Determine eligibility for and access new federal financial assistance, based on income Support the health coverage decision-making process Call, text or sit down with trained representative for help Enroll in a health plan 6

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing >$92,200 for a family of four; >400% of FPL  Job-based coverage, or  Full-cost coverage in the exchange $65,150-$92,200; % of FPL  Job-based coverage, or  Subsidized exchange coverage: premiums capped at 9.5% of income $46,100-$69,150; % of FPL  Job-based coverage, or  Subsidized exchange coverage: premiums and copays to 250% $30,657-$46,100; /250% of FPL CHP+ Job-based coverage, or Subsidized exchange coverage: premiums and copays <$30,657 for a family of four; < 133% FPL Medicaid Children and pregnant women Adults (non-disabled adults, not eligible for Medicare) Family Income Coverage Options by Income Citation: The Center for Public Policy Priorities ( )

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing 758, , , ,000 Health Insurance Status after Implementation

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Insurance reforms Insurance Accountability Dependent care coverage for adult children to age 26 No pre-existing conditions exclusions for children No lifetime limits No rescissions Medical Loss Ratio to 80% ind. market and 85% large group market (2010 reporting, 2011 rebates) Free preventive care (new plans) No annual limits Guaranteed issue Guaranteed renewability No gender rating No health status rating Age rating 3:1; Geographic variation/tobacco rating 1.5:1

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Bending the cost curve Coordinated Care Models in Colorado – Patient-Centered Medical Homes – Accountable Care Collaboratives – Reforming payment systems (HB1281) – Leveraging health information technology Preventing and Managing Chronic Disease Cost Containment

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Accountable Care Collaborative Update The Department reduced Medicaid health costs by $20 million Returned nearly $3 million to state and federal taxpayers since its inception Indicators- ACC Clients Hospital Readmissions 8.6% reduction Emergency Room Utilization.23% increase High-Cost Imaging3.3% reduction 11

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Questions Lorez Meinhold Deputy Executive Director/ Director of Community Partnership Office 1570 Grant Street Denver, CO (303)