1. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Colorado Department of Health Care Policy & Financing

2. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources Our Mission: 2

3. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Health In Colorado 22% of adults obese; 14.2% kids 18.3% working age adults uninsured; 9.3% kids 20.7% of women receive initial prenatal care later than the first trimester or not at all 28.7% of preschool-age children do not receive all recommended doses of six key vaccines. 14.8% of adults reported having poor mental health

4. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Coverage Medicaid expansions up to 133% of poverty Premium tax credits available up to 400% of poverty Cost sharing subsidies up to 250% of poverty (limits out of pocket spending) Investments in workforce and clinic capacity Coverage

5. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Medicaid Expansion: The Right Choice for Colorado (SB13-200) Maximizing enhanced federal funding is the best option for Colorado o Allows provider fee dollars to stretch further with the enhanced federal matching funds o The Medicaid expansion is expected to have no impact on the state General Fund Expansion allows Medicaid to cover more than 160,000 additional Coloradans o Expansion allows us to cover more people with the right services at the right time and drive value in the system o 58,000 additional parents and adults likely to enroll between 100%-133% of FPL (138% with an automatic 5% income disregard) o In 2013, 133 percent of the FPL was $31,321 for a family of four and $15,282 for an individual o Supports Colorado’s health and economy by helping people stay healthier over the long term

6. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Cost of Expansion 6 Preliminary 10-YEAR ESTIMATE* Caseload and Cumulative Expenditure Projections, 2013-2022 (Representing Net Change, Costs in Millions) 09-1293ACA**Total Caseload 1 220,30059,500271,000 Total Cost$11,709.7$2,039.2$13,548.3 State Share: Provider Fee/ Other 2 $1,267.3$128.3$1,395.6 State Share: GF/Other 2 $0 ($179.5) Federal $10,382.3$1,910.9$12,280 *This is a preliminary estimate of caseload and expenditures and does not include administrative costs or effects of other programs. **The total estimates column above takes into account calculations for eligible but not enrolled individuals and changes to the CHP+ costs and caseload. 1 An estimated more than160,000 Coloradans will be enrolled as a result of the expansion. This is difference between 271,000 (above) and an estimated 110,200 parents and adults without dependent children currently authorized under the provider fee. 2 As federal funding tapers, we anticipate savings, provider fees and other public funding will cover the additional caseload.

7. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing 758,000 160,000 220,000 160,000 Health Insurance Status after Implementation

8. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Insurance reforms Insurance Accountability 20102014 Dependent care coverage for adult children to age 26 No pre-existing conditions exclusions for children No lifetime limits No rescissions Medical Loss Ratio to 80% ind. market and 85% large group market (2010 reporting, 2011 rebates) Free preventive care (new plans) No annual limits Guaranteed issue Guaranteed renewability No gender rating No health status rating Age rating 3:1; Geographic variation/tobacco rating 1.5:1

9. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Bending the cost curve Coordinated Care Models in Colorado – Patient-Centered Medical Homes – Accountable Care Collaboratives – Reforming payment systems (HB1281) – Leveraging health information technology Preventing and Managing Chronic Disease Cost Containment

10. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Improving Value in Medicaid: $280 million in savings over 10 years Enhancing value-based services Increasing effectiveness in care delivery Reforming payment systems to reward value instead of volume Leveraging health information technology to improve quality and efficiency of care Redesigning administrative infrastructure and reducing fraud, waste and abuse 10

11. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Accountable Care Collaborative Update The Department reduced Medicaid health costs by $20 million Returned nearly $3 million to state and federal taxpayers since its inception Indicators- ACC Clients Hospital Readmissions 8.6% reduction Emergency Room Utilization.23% increase High-Cost Imaging3.3% reduction 11

12. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Payment Reform Courtesy: Colorado Health Institute 10

13. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing >$92,200 for a family of four; >400% of FPL  Job-based coverage, or  Full-cost coverage in the exchange $65,150-$92,200; 300-400% of FPL  Job-based coverage, or  Subsidized exchange coverage: premiums capped at 9.5% of income $46,100-$69,150; 200-300% of FPL  Job-based coverage, or  Subsidized exchange coverage: premiums and copays to 250% $30,657-$46,100; 133-200/250% of FPL CHP+ Job-based coverage, or Subsidized exchange coverage: premiums and copays <$30,657 for a family of four; < 133% FPL Medicaid Children and pregnant women Adults (non-disabled adults, not eligible for Medicare) Family Income Coverage Options by Income Citation: The Center for Public Policy Priorities ( www.cppp.org )

14. Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing Questions Lorez Meinhold Deputy Executive Director/ Director of Community Partnership Office 1570 Grant Street Denver, CO 80203 (303) 866-5868 lorez.meinhold@state.co.us