1. The Affordable Care Act (ACA) and What It Means for Latinos
An Overview by the Kaiser Family Foundation for Univision Affiliates
Webinar Briefing
June 19, 2013

2. Today’s Speakers Claudia Deane Samantha Artiga Tina Hoff Larry Levitt
Associate Director for Public Opinion & Survey Research
Samantha Artiga
Director of Disparities Policy Project
and
Associate Director of the Kaiser Commission on Medicaid and the Uninsured
Tina Hoff
Senior Vice President
and
Director of Health Communication and Media Partnerships
Larry Levitt
Senior Vice President for Special Initiatives
and
Co-Executive Director of the Program for the Study of Health Reform and Private Insurance

3. 1. The Basics of the Affordable Care Act (ACA)
New and Increased Coverage Options available starting in 2014
For states that chose to, Medicaid will be expanded to cover adults with incomes up to 138% of the federal poverty level (about $16K per year for a single person, $21K for a couple).  The Supreme Court ruling on the ACA changed the expansion from a nationwide action to a state option.
New health insurance “marketplaces” (also called “exchanges”) will provide options for individuals buying insurance on their own and for small businesses. Enrollment begins Oct thru March 31, Tax credits will be available to persons with incomes from 100% to 400% of the federal poverty level (about $46K for an individual and $94K for a family of four) to help offset costs.
Employers with 50+ workers must offer affordable insurance to their workers or pay a penalty.
As of end of 2010, parents are now able to keep children on their insurance up to age 26.
Insurance Market Reforms Taking Effect in 2014
Insurers will be required to provide coverage to everyone regardless of pre-existing health conditions. Variations in premiums limited for age and prohibited for gender and health status.
All insurance plans sold to individuals and small businesses will have to provide a minimum level of coverage, including preventive care, maternity, mental health, and prescription drugs.
To help these reforms work and keep premiums down, most Americans will be required to have insurance or pay a penalty (the “individual mandate”).

4. 2. At Three Years Public Opinion on ACA Remains Divided
As you may know, a health reform bill was signed into law in Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it?
ACA signed into law on March 23, 2010
SOURCE: Kaiser Family Foundation Health Tracking Polls

5. 3. Ongoing Partisan Divide on ACA
Percent who say they have a favorable opinion of the health reform law:
ACA signed into law on March 23, 2010
SOURCE: Kaiser Family Foundation Health Tracking Polls

6. 4. More Hispanics Lean Favorably Toward ACA
As you may know, a health reform bill was signed into law in Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it?
ACA signed into law on March 23, 2010
AMONG HISPANICS
SOURCE: Kaiser Family Foundation Health Tracking Polls

7. 5. Spanish-Dominant Hispanics Most Favorable Views Toward ACA
As you may know, a health reform bill was signed into law in Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it?
Hispanics by Language Preference
SOURCE: Kaiser Family Foundation Health Tracking Polls (conducted April 15-20, 2013 and June 4-9, 2013)

8. 6. Two in Three Hispanics Feel Uninformed About Law
Do you feel you have enough information about the health reform law to understand how it will impact you and your family, or not?
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted April 15-20, 2013)

9. Insurance Coverage of Nonelderly in the U.S. by Race/Ethnicity, 2011:
7. Hispanics are at Highest Risk of Being Without Insurance Compared to Other Races/Ethnicities
Insurance Coverage of Nonelderly in the U.S. by Race/Ethnicity, 2011:
Non- Workers
22%
High School
1 or More
Full-Time
35-54
34%
1 or More Full-Time
62%
Non-Workers
White
26-34
21%
Less Than
High School
161.6 M
14.7 M
33.5 M
1.9 M
49.2 M
SOURCE: KCMU/ Urban Institute analysis of 2012 ASEC Supplement to the CPS.

10. At Least 1 Full-Time Worker
8. Most Uninsured Hispanics are in Working Families; More than Half are under the age of 26
Characteristics of 15.5 Million Nonelderly Uninsured Hispanics in the U.S.
Family Work Status
Age
Citizenship Status
At Least 1 Full-Time Worker
68%
SOURCE: KCMU/ Urban Institute analysis of 2012 ASEC Supplement to the CPS.

11. 9. ACA Expands Access to Health Insurance Coverage
Medicaid/CHIP
Unsubsidized
Marketplace Coverage
Premium Tax
Credits
Plan A
Plan B
Plan C 
John Doe
123 Main Street
12345
Created by JS (3/8/2013)
Kaiser Slide – Health Reform set
Eligibility for Multiple Programs Determined in
Real Time
Information Provided
on Available Plans
for Comparison
Enrollment Into Selected Plan

12. 10. Most Uninsured Hispanics are at Income Levels that Qualify for Medicaid Expansion or Subsidies
Health Insurance Status among the 49.2 Million Non-Elderly Hispanics in the U.S.
15.5 Million Non Elderly Uninsured Hispanics By Income Level
≥400% FPL
(5%)
% FPL
Subsidies (38%)
≤138% FPL
Medicaid (57%)
Employer-Sponsored
Coverage/Other Private
39%
Uninsured
Uninsured
Medicaid/ Other Public
Medicaid*
30%
SOURCE: KCMU/ Urban Institute analysis of 2012 ASEC Supplement to the CPS.

13. Medicaid Eligibility Today
11. The ACA Medicaid Expansion Extends Eligibility to
Low-Income Adults
Medicaid Eligibility Today
Medicaid Eligibility
in 2014
Pregnant
Women
Extends to Adults
≤138% FPL*
Elderly &
Persons with Disabilities
Kaiser Slide – Health Reform set
Children
Parents
Adults up to
138% FPL

14. 12. Current Status of the Medicaid Expansion Decision as of June 14, 2013WY WI WV WA VA VT UT TX TN SD SC RI PA OR OK OH ND NC NY NM NJ NH NV NE MT MO MS MN MI MA MD ME LA KY KS IA IN IL ID HI GA FL DC DE CT CO CA AR AZ AK AL
Moving Forward at this Time (24 States including DC)
Debate Ongoing (7 States)
Not Moving Forward at this Time (20 States)
SOURCE: Based on KCMU analysis of recent news reports, executive activity and legislative activity in states.

15. 13. Hispanics have High Stakes in State Decisions to Expand Medicaid
Distribution of Uninsured Hispanics who are Income Eligible for Medicaid Expansion (8.9 Million)
44%
in States Not Moving Forward at this Time
(20 States)
52% in States Moving Forward at this Time
(24 States)
SOURCE: Based on KCMU analysis of 2011 American Community Survey.

16. 14. State Health Insurance Marketplace Decisions as of May 28, 2013WA OR WY UT TX SD OK ND NM NV NE MT LA KS ID HI CO CA AR AZ AK WI WV VA TN SC OH NC MO MS MN MI KY IA IN IL GA FL AL VT PA NY NJ NH MA ME CT DE RI MD DC
State-based Marketplace (16 states and DC)
Partnership Marketplace (7 states)
Federally-facilitated Marketplace (27 states)

17. 15. Outreach and Enrollment Resources for Hispanics
Outreach and education campaigns will ramp up in Summer 2013
October 2013: Open enrollment for Marketplace coverage begins
January 2014: Start date for Marketplace and Medicaid expansion coverage
March 2014: Initial open enrollment period for Marketplace coverage ends
Enrollment in Medicaid is not limited to the open enrollment period
Outreach initiatives
HHS/CMS
States
Enroll America and other private initiatives
Resources to direct individuals for more information
Healthcare.gov
National and state call center help lines
Network of certified “assisters” or “navigators”
Community health centers
National Alliance for Hispanic Health Buena Salud Club and Su Familia Provider Database
-- Subsidy Calculator from Kaiser Family Foundation:

18. 16. Key Issues to Watch How will implementation vary by state?
How many people are signing up for new coverage options? Are the young and healthy getting insured as well as those who are sick? How does gaining insurance impact individuals’ health care and personal lives?
How many states expand Medicaid? What will expansion decisions mean for coverage and costs? For efforts to reduce health care disparities? What happens to poor adults who do not gain a new coverage option in states that do not expand Medicaid?
Are the new marketplace insurance options affordable, taking into account tax credits for low and middle income people? How competitive are the new insurance marketplaces? Are new, local plans entering the market?
What happens to the safety-net for those left out of expanded insurance?
There will be technical glitches in the new marketplaces. Are they widespread or anecdotal? Are they addressed quickly? Are people getting the help they need to understand new coverage options and enroll?
How well do education, outreach, and enrollment efforts meet the language and cultural needs of the community?
How are employers reacting? Are they expanding health benefits or paying the penalty?

19. Q&A
Please use the chat function within your webinar screen to submit questions to our speakers.

20. Please visit our website: www.kff.org/health-reform-resources
For more information
Please visit our website:
Contact: Tina Hoff at