1. Rural Health Policy Summit Barney Speight June 11, 2010

2. 2 Since July, 2009: –44,966 kids have been enrolled in Healthy Kids (16.65% increase) –13,733 kids in rural counties (30.5%) Oregon Healthy Kids: Enrollment Gains

3. 3 County# Increase% Increase Baker20016.86 Clatsop44418.69 Columbia60120.15 Coos60211.97 Crook36522.97 Curry22018.79 Douglas1,22014.45 Gilliam3444.74 Grant43913.90 Harney50921.81 Hood River22410.30 Jefferson27710.52 Josephine1,18016.21

4. 4 County# Increase% Increase Klamath86414.98 Lake549.84 Lincoln50814.67 Linn1,64816.95 Malheur66318.21 Morrow15613.87 Polk83815.55 Tillamook22213.14 Umatilla1,04714.72 Union28214.44 Wallowa4110.82 Wasco34816.63 Yamhill1,44619.45

5. 5 Prioritizing areas with high rates of uninsurance Reaching out to: –Clinics, business groups, ag community –Faith-based groups –4-H –County fair guides –Oregon High School Rodeo finals in Crook county HK Outreach & Marketing in Rural Oregon

6. 6 www.oregonhealthykids.gov www.facebook.com/OregonHealthyKids For More Information…

7. 7 Coverage Expansions Under P.L. 111-148 1.New mandatory Medicaid eligibility category 2.For individuals who buy through an Exchange: –Premium assistance through refundable tax credit –Reduced cost-sharing

8. 8 Non-elderly, non-pregnant persons not entitled to Medicare; i.e., childless adults & certain parents With incomes at or below 133% FPL Medicaid Expansion in 2014

9. 9 Premium assistance credit –Sliding scale: Premium cost at 2% (100% FPL) to 9.8% (400% FPL) Maximum out-of-pocket limits reduced from $5,950 individual / $11,900 family –100-200 FPL: $1,964/$3,927 –200-300 FPL: $2,975/$5,950 –300-400 FPL: $3,927/$7,854 Subsidies in an Exchange in 2014

10. 10 Uninsured in Oregon by FPL (2008) FPL# Oregon% Oregon 100 - 133300,70048.4 134 - 400222,000+35.8+ Over 40063,00010.2 Total620,600100.

11. 11 Regional Uninsurance Rates in Oregon (2008) RegionUnder 200% FPLOver 200% FPL Umatilla, Union, Wallowa, Baker 31.1% (14,132)11.1% (7,677) Crook, Gilliam, Grant, Hood River, Jefferson Morrow, Sherman, Wasco, Wheeler 38.1% (14,009)15.9% (11,292) Harney, Klamath, Lake, Malheur 30.0% (13,012)12.7% (8,337) Clatsop, Columbia, Lincoln, Tillamook 33.7% (18,759)10.8% (10,733) Coos, Curry, Josephine 28.9% (18,611)12.1% (12,185) Douglas 22.0% (8,651)13.8% (8,823) Polk, Yamhill 19.8% (9,307)8.9% (10,484)

12. 12 Delivery system capacity –WORKFORCE I. T. –Connectivity between Exchanges, HHS/CMS, IRS, State of Oregon, Health Plans, etc. –Interoperability of clinical information systems (EMRs, EHRs, etc.) –To be addressed by next presenters…. Strategic Implications