Health Reform in Kentucky: Where are we now? Anne Hadreas August 17, 2012 Welfare and Health Task Force

What this will cover SCOTUS decision Exchange Medicaid expansion What is effect now

Supreme Court Individual mandate constitutional under taxing power, not Commerce Clause Medicaid Expansion coercive, but fixable Everything else stays…probably

State Exchange Gov. Beshear used an executive order to initiate Exchange State government based 11 member advisory board (2 consumer reps) Will include Medicaid MCOs

Premium Tax Credits Subsidies available from federal government Covering households with incomes between 100% and 400% of FPL Can only be used on the exchange

Medicaid Expansion Approximately 300,000 Kentuckians affected 3.5% increase in state Medicaid costs (but will have other savings) Targeted groups We need stories!

What is already in effect? Help for older Americans o 50% discount for name-brand drugs in the Medicare "donut hole“ ($68 million saved by KY) o Early retiree fund

What is already in effect? Help for children and young adults o Ability to stay on parents’ insurance until age 26 (48,000 Kentuckians) o No denial for pre-existing conditions

What is already in effect? Insurance reforms o No rescission for health changes o External review process for insurance denials o Lifetime limits gone o PCIP plans

No Co-Pay Preventive Services Medicare (over half a million in 2011) Women’s health (including contraception) All adults (including immunizations)

Medical Loss Ratio Check should be coming now 249,275 Kentucky residents with private insurance coverage will benefit from $15,326,103 Average of $114/family

Questions? Anne Hadreas (859)