2. REALIGNING THE HEALTH CARE SAFETY NET Health Action 2014: Making the Promise Real Presented by: DaShawn Groves, MPH Assistant Director of State Affairs National Association of Community Health Centers January 23, 2013

3. America’s Voice for Community Health Care The NACHC Mission To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved people.

4. TODAY’S AGENDA Health Centers Today ACA Implementation –Health Center Funding –Medicaid –Marketplaces –Outreach and Enrollment How you as advocates can help?

5. Health Center Funding

6. Health Center Funding Under Current Law Community Health Center Funding: FY 2010 – FY 2016

7. The Health Center FY2014 Request Total Funding of $3.8 billion, breaks down to: ~$1.6 billion in discretionary funding ~$2.2 billion in mandatory ACA Funding __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ = increase of $700 million– No new appropriations needed (Level discretionary + already-appropriated ACA dollars) What $700 Million can do...  $95 million in Base Grant Adjustments  $245 million for NAPs= 2.1 million new patients  $260 million for service expansions and expanded medical capacity grants for existing health centers.  $100 million for quality improvement, networks, other activities.

8. What purpose does the grant serve today? Enables CHCs to: Locate in underserved areas where market won’t support other providers; Remain open to all: uninsured, underinsured, patients others can’t or won’t see; Provide comprehensive services which improve health and lower system costs. What role does the grant have in the future? The exact same. The Health Center Grant

9. Medicaid

10. Sequester Defund ACA Debt Ceiling FY 2014 Approps SGR “Doc Fix” Immigration Reform To Expand or Not to Expand?

11. A Tale of Two Cities Massachusetts Experience –LOTS more patients; existing patients voting with their feet (and staying); continued high #’s of uninsured Business as Usual –Disparities amongst health centers

12. Marketplaces

13. Health Centers in Marketplaces Contracting issues Essential Community Providers (ECP) –“Menendez” amendment; –“all products” clauses

14. Outreach and Enrollment

15. 9 Source: www.hrsa.gov/about/news/2013tables/outreachandenrollment/

17. Outlook We will continue to SUCCEED and GROW Value in the quality care we deliver Value in expanding access and improving health Value in delivering cost savings PLUS some $20 billion dollars in jobs and economic activity for communities. 202-457-6267

18. Where Can I Get More Information? Our Website: – NACHC.org NACHC.org Blog: – Health Centers on the Hill Health Centers on the Hill – NACHC Policy Shop Washington Update: – Sign up to be a Health Center Advocate Sign up to be a Health Center Advocate Join the Campaign for America’s Health Centers today!Campaign for America’s Health Centers

19. Thank You! Any Questions?