1. King County Fire Chiefs June 19, 2013 King County Outreach and Enrollment Strategy

2. Overview of today’s presentation A.So what, again, is happening? B.Why is this important? A look at who’s currently uninsured in King County C.How are we planning to enroll these folks?

3. What is happening? Beginning January 1, 2014 Everyone has to have health insurance: –Penalties for not obtaining insurance (greater of 1% of income or $95, increasing over time) –Subsidies available for low-income Employers: –More than 50 employees must provide insurance. Penalties for those that don’t –Less than 50 employees exempted but incented through tax credits

4. Why is this important in King County? On many measures, overall rates favorable in King County compared to US metro counties Wide disparities by place, race/ethnicity, education and income within King County Disparities among largest in the U.S. in some determinants of health, including insurance 4 Next 5 Slides: Public Health-Seattle & King County’s Assessment, Policy Development, Evaluation Section (APDE)

7. 2012

8. Uninsured 3% - 30% Healthcare insurance access Seattle Kent Bellevue Auburn Renton Bothell Federal Way Redmond Sammamish SeaTac Kirkland Shoreline Burien Tukwila Issaquah Kenmore Covington Des Moines Woodinville Mercer Island Maple Valley Newcastle Black Diamond Pacific Duvall Lake Forest Park Medina Algona Normandy Park

9. Healthcare insurance access After Healthcare reform: 1% to 10% uninsured 4% overall 2014 Lowest Seattle Kent Bellevue Auburn Renton Bothell Federal Way Redmond Sammamish SeaTac Kirkland Shoreline Burien Tukwila Issaquah Kenmore Covington Des Moines Woodinville Mercer Island Maple Valley Newcastle Black Diamond Pacific Duvall Lake Forest Park Medina Algona Normandy Park

10. How will this happen? 1.Medicaid for individuals with incomes up to 138% of poverty. No or low monthly premiums/cost sharing 2.Health insurance Exchange –Subsidized premiums and tax credits for individuals with incomes 139% to 400% of federal poverty level (FPL) –Platinum to bronze health plans (same benefits, different cost sharing) –WA Healthplanfinder will allow people and businesses to compare health insurance plans and learn about subsidies and tax credits

11. wahealthplanfinder.org

12. FPL Eligibility today and in 2014

13. Bottom line: 180,000 newly eligible New Medicaid coverage for about 80,000 uninsured King County residents Affordable insurance options for over 100,000 uninsured individuals and about 68,000 small businesses through the Exchange In addition there are about 37,000 above 400% FPL who will be required to purchase their own insurance.

14. Who’s left uninsured after ACA? Undocumented immigrants. Certain religious groups, Native American tribes, and incarcerated. Eligible people who are not enrolled. Immigrants here legally for 5 years are eligible for Medicaid; those here less than 5 years are eligible for the Exchange. Our job is to get everyone who is eligible enrolled.

15. 15  Oct 1 2013  Jan 1 2014 Coverage starts  March 31 2014  Dec 7 2014 Timeline for enrolling newly eligible  Oct 15, 2014 Exchange open enrollment Medicaid enrollment

16. King County Outreach & Enrollment Plan For the uninsured: Education and encourage enrollment through multiple communications and outreach strategies Targeted enrollment assistance to newly eligible at convenient sites For employers: Education and outreach to businesses

17. Challenges We Face Confusion about what health reform is and how it affects the community Uninsured individuals will not necessarily take the initiative to get coverage on their own Education alone is not enough—some individuals, especially the most vulnerable, will need extra help with the enrollment process

18. Partners in this Effort 1.Fire Chiefs? 2.King County Cities & Seattle Districts 3.Health care partners 4.Colleges/Universities/Tech Schools/High Schools 5.Libraries 6.Community Centers 7.Housing providers 8.Services providers for the homeless 9.Criminal justice system 10.Public Health’s specialty health programs (e.g., HIV/STD clinic, needle exchange) 11.More to come…

19. Questions and Discussion Jennifer DeYoung Health Reform Policy Analyst chrissy.russillo@kingcounty.gov Daphne Pie Access and Outreach Manager, Community Health Services daphne.pie@kingcounty.gov