Affordable Care Act in Massachusetts Training PFAC Webinar Series Kate Bicego, Health Care For All

Health Care For All o Non-profit advocacy and health information organization. Goal is quality and affordable health care. o HelpLine: o Health Law Advocates: o Blog: blog.hcfama.org o Website:

Where are we right now? “Thank you, Chapter 58!”

MassHealth (Medicaid ) o Health insurance coverage for long-term unemployed people, low-income parents & their children, some pregnant women, & some disabled people. o Can sometimes help pay for work insurance that is unaffordable to families

Commonwealth Care o Health insurance coverage for adults (19+) who are not eligible for MassHealth or insurance through a job o Lower monthly premiums and co-pays o Choice of health plans o Network Health, BMC HealthNet, NHP, Celticare, or Fallon

Who qualifies right now? o MassHealth o Household with children <19 living in home o Single person +1 child, ~$20,000 /year o Family of four, ~$31,000 /year o Pregnant women o Single woman, ~$31,000 /year o Family of four, ~$55,000 /year

Who qualifies right now? o Commonwealth Care o Adults (19+) o Single adult, ~$34,000 /year o Family of four, ~$70,000 /year Cannot have access to health insurance through a job Cannot get unemployment benefits Cannot qualify for school insurance (FTE students)

Other Health Care Options o Employer or private health insurance o Health Safety Net (free care) o Children’s Medical Security Plan

Opportunities for Improvements o No “wrong door” to insurance o Higher income limits o Easier application and enrollment o On-going coverage (fewer gaps)

Affordable Care Act History being made on March 23 rd, 2010!

Insurance Market Reforms No denials or charging more for pre-existing conditions Insurance plans must provide an understandable Summary of Benefits and Coverage No lifetime or annual limits on coverage No cost sharing (co-pay, deductible, or coinsurance) for certain preventive services Insurance must cover doctor’s visits, maternity services, ER care, and prescriptions Insurance companies no longer cancel coverage*

Insurance Market Reforms *Your insurance company can still cancel coverage if you: Put false or incomplete information on your insurance application on purpose or You don’t pay your premiums on time.

ACA Impact in Massachusetts How will the ACA help more people in Massachusetts to afford health insurance coverage?

Major ACA Improvements in Mass. More people will qualify MassHealth! More help paying for health insurance from the Health Connector!

More Help Paying for Health Insurance! o MassHealth o Most adults (including students) eligible up to 133% FPL o Single adults: ~$15,000/year o Family of four: ~$31,000/year o Help paying for private insurance o Families eligible up to 400% FPL o Single person: ~$46,000/year o Family of four: ~$94,000/year

New Income Limits for Help Paying for Health Insurance Household Size MassHealth CarePlus 138% FPL ConnectorCare 139% - 300% FPL Help Paying for Qualified Health Plans From Health Connector 301%-400% FPL 1$15,288$34,472$45,960 2$20,640$46,536$62,040 3$25,980$58,596$78,120 4$31,332$70,656$94,200 5$36,672$82,716$110,280 6$42,024$94,776$126,360

The Health Connector is getting better! o The Health Connector is the one-stop shop for health insurance in the state. o What gets better? o 1 online application o Help paying for health insurance up to 400% FPL

Other Health Coverage Options in Mass. o Employer health insurance o Parent’s health insurance o Health Safety Net (free care) o Children’s Medical Security Plan

Affordable Care Act Coverage Transitions Who needs to reapply and reenroll for their new health insurance coverage?

No one currently in MassHealth needs to reapply unless one of their household members needs to reapply.

Commonwealth Care members under 133% FPL do NOT need to reapply.

The “Pink Notice”

Commonwealth Care members over 133% FPL DO need to reapply NOW.

Reapply Notice

All Commonwealth Choice and Commonwealth Care members need to reapply and reenroll by March 24 th, 2014.

Additional Reapply All Medical Security Plan (MSP) members All documented immigrants Anyone that has been denied Commonwealth Care in the past that may now qualify Anyone that has been denied MassHealth in the past that may now qualify

Over Age 65 & the Affordable Care Act No change in Medicare process No change in MassHealth If family has members 65, apply for entire family using both new application & paper application

ACA Changes in Massachusetts: Case Examples Rosa is a 58 year old married woman that has been unemployed since she lost her job during the recent recession. Her household’s only income is $1,500 per month in Social Security benefits. How can Rosa get health insurance help because of the ACA?

ACA Changes in Massachusetts: Case Examples Janet is an uninsured single mother with three children living in her home. She is self-employed and earns about $85,000 per year. How will the ACA help Janet get affordable health insurance?

Resources o For more information about the Affordable Care Act: o Health Connector: orwww.mahealthconnector.org 877-MA-ENROLL o Health Care For All: or call our FREE health insurance HelpLine at www.hcfama.org Counselors are available to take calls in English, Spanish, and Portuguese.

Speaker Contact Info Kate Bicego Consumer Assistance Program Manager Health Care For All

Questions???

Future Webinars Wednesday, January 8: 1:00-2:00pm Topic: PFACs Working to Improve Mental Health Care Future webinars: The second Wednesday of every month (February 12, March 12, April 9, June 11, July 9, September 10, October 8, November 12, December 10). Wednesday May 14: Second Annual Statewide PFAC Conference at the College of the Holy Cross