ACA & INDIAN COUNTRY: BARRIERS, ADVOCACY & OVERCOMING OBSTACLES Jim Roberts, Policy Analyst NIHB Annual Consumer Conference September 10, 2014 Albuquerque,

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Presentation transcript:

ACA & INDIAN COUNTRY: BARRIERS, ADVOCACY & OVERCOMING OBSTACLES Jim Roberts, Policy Analyst NIHB Annual Consumer Conference September 10, 2014 Albuquerque, NM

HHS Data State Total No. Determined Eligible to Enroll in a Marketplace Plan No. of Individuals Eligible to Enroll with Financial Assistance Number of Individuals Who Have Selected a Marketplace Plan United States13,547,5928,748,0378,019, %91.7% Idaho107,84983,66276, %90.9% Oregon124,84099,90268, %68.4% Washington240,880151,441163, %108%

Washington State Enrollment

WA State QHP Enrollments

Who Expanded Medicaid: Low ACA enrollments indication many AI/AN going into Medicaid

Challenge to evaluating AI/AN Participation in ACA 1. Lack of AI/AN enrollment data in both the FFM and SBE 2. Can not effectively evaluate take up rates for AI/AN participation in ACA 3. Enrollment could be improved by developing Tribal sponsorship programs and group payer arrangements 4. Resolving QHP contracting issues with I/T/U providers could also improve enrollment

Portland Area Training: “Lesson Learned & Things to prepare for” World Cafe Discussion on many issues including Lessons Learned and what we found: Many AI/ANs excited to have options for insurance! Through research and patience Navigators and Assisters able to work through most problems Exchange websites worked less than 50% of the time Paper Applications proved most effective and still required phone follow up Communications between Exchange and state Medicaid programs has problems Lengthy wait times on phone lines The process overpromised and under delivered

Portland Area Training: “Lesson Learned & Things to prepare for” Premium miscalculation on mixed households is a real problem Application assistance if AI/AN has been assigned to another navigator or assister – locked out Call Centers are not always helpful and in many instances cause more confusion Tribal navigators listed publically Applications for Exemptions needs to be improved State staff and call centers do not have Tribal experts and return calls take a very long time QHP contracting and reimbursement is unclear

Questions?