1. A Presentation of the Colorado Health Institute 303 E. 17 th Avenue, Suite 930 Denver, Colorado 80203 www.coloradohealthinstitute.org @CoHealthInst (Twitter) Health Insurance Exchanges Sponsored by CO AHEC Program and Central CO AHEC Presentation : Health Insurance Exchanges by Joan Henneberry, CO Health Institute Date: 2/2/2011 Meeting AHEC/CHI

2. Agenda for presentation 1.Welcome 2.Introduction to keypads 3.Questions Central AHEC and COAHEC – Demographics and attitudes about the health care system and federal reforms 4.Health Insurance Exchanges 1

3. Simply push the key that corresponds with your answer choice It will turn on when you push a numbered key Using your Keypads 2

4. Your answer will be displayed on the keypad. Let’s say you press 2/B on your keypad: The check mark indicates the answer was received properly. Polling Open Note: after your selection is displayed the screen will go blank 3

5. As long as Polling is Open, you can change your answer by pressing any other key. Polling Open 4

6. What is your general view of the healthcare legislation Congress passed earlier this year? 5 1.Love it 2.Hate it 3.Mixed emotions 4.Need more information in order to understand it 5.Other

7. Demographic questions Who is in the room? 6

8. What is your race/ethnicity? American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Hispanic Unknown More than one race Other 7

9. What is your gender? 1.Male 2.Female 8

10. What is your age range? 1.<20 years old 2.20 to 29 years old 3.30 to 39 years old 4.40 to 49 years old 5.50 to 59 years old 6.>60 years old 9

11. I live in: 1.Denver Metro 2.Front Range 3.Northeast 4.Southeast 5.Mountain 6.San Luis Valley 7.Western Slope 8.Other 10

12. Are you a… 1.Native of [this town/ county/region]? 2.Native of Colorado? 3.Native of another U.S. state? 4.Native of another country? 11

13. A Presentation of the Colorado Health Institute 303 E. 17 th Avenue, Suite 930 Denver, Colorado 80203 www.coloradohealthinstitute.org @CoHealthInst (Twitter) Health Insurance Exchanges Joan Henneberry Date 2/2/2011 Meeting AHEC/CHI 12

14. Affordable Care Act The Patient Protection and Affordable Care Act (H.R. 3590) was signed into law on March 23, 2010 by President Obama. Provisions can be categorized into 4 broad buckets: – Medicare Reform – Insurance Reform – Medicaid Reform – Other Provisions 13

15. Insurance Reforms All U.S. Citizens are required to have qualifying health care coverage by 2014. Requires guarantee issue and renewability, prohibits pre-existing condition exclusions. Prohibits lifetime limits on the dollar value of coverage. Provides dependant coverage for children up to age 26. Creates a temporary national high-risk pool for individuals with pre-existing conditions, effective through January 2014; enrollment began 7/6/10 Creates temporary reinsurance program for plans that cover high-risk individuals, apps accepted 7/1/10 14

16. Medicaid Reform Medicaid is expanded to all individuals with incomes up to 133% FPL. All newly eligible adults are guaranteed a benchmark benefit package that provides at least essential health benefits. Federal funding for newly eligible: – 100% from 2014 through 2016 – 95% in 2017 – 94% in 2018 – 93% in 2019 – 90% in 2020 and thereafter 15

17. The Exchange Creates state-based American Health Benefit and Small Business Health Options Program (SHOP) Exchanges through which individuals and small businesses can purchase qualified coverage. Individuals between 133%-400% FPL receive federally financed premium credits to purchase insurance through the Exchanges, as well as cost- sharing credits. Eligibility for subsidies and public coverage based on Modified Adjusted Gross Income (MAGI), which conforms to income tax definitions. 16

18. Exchange Administrative Functions Eligibility, Verification, Enrollment – Coordination with Medicaid – Referrals to other programs – Coordination with IRS State-of-the-art virtual customer service – Website – Call Center Standards for plans and networks Back room functions – Reporting, program integrity, exchange of funding/payments 17

19. Coverage in 2020 19 Employer-Sponsored Insurance- 3,300,000 Medicaid – 1,200,000 Medicare – 1,000,000 Exchange – 300,000 18

20. Example of an On-line Exchange State of Wisconsin has developed a mock exchange https://exchange.wisconsin.gov/exchange/webCo ntroller?id=0.6562172112083888 20

21. How often do you buy something online? 21 1.None of my purchases 2.Sometimes I purchase items 3.Most of my purchases 4.All of my purchases

22. How will you purchase your policy? 22 1.On-line 2.Through a broker or navigator 3. Utilize both avenues

23. What is important to you in a policy? 23 1.Low monthly premiums 2.Low out of pocket expenditures 3.Network adequacy 4.Geographic convenience, or access to a providers Please pick 3

24. What is your general view of the healthcare legislation Congress passed earlier this year? 5 1.Love it 2.Hate it 3.Mixed emotions 4.Need more information in order to understand it 5.Other

25. Contacts Joan Henneberry Director, Colorado Health Insurance Exchange henneberryj@coloradohealthinstitute.org Lorez Meinhold Health Reform Implementation Coordinator Lorez.meinhold@state.co.us www.colorado.gov/healthreform 19