1. » United Way of Southeast Louisiana Public Policy Committee Educational Session: Medicaid Maximization October 8, 2013 Dr. Karen DeSalvo, Health Commissioner, City of New Orleans

2. Why Health Coverage Matters Profile of the Uninsured 780,000 people in LA – the typical uninsured person is:  Ages 18-64  Male  White, non-Hispanic  Native born  High school graduate  Employed  Living below 138% of federal poverty line (FPL)  Food service, construction, retail, health care, child care, school, and hotel workers.  679 people die in Louisiana annually as a result of being uninsured  The cost of caring for the uninsured amounts to a $1,000/year “hidden” tax on those with private insurance

3. The Affordable Care Act: 3 Key Provisions 1.Insurance reforms: guaranteed issue, modified community rating, no pre-existing condition exclusions 2.Coverage expansion – through Medicaid, up to 138% FPL 3.Coverage expansion – through Private Health Insurance on the Marketplace ACA is financed through:  Medicare payment cuts and savings  Disproportionate Share Hospital payment cuts  New taxes

5. 2005 Hurricane Katrina and Levee Failures 2006 Louisiana Healthcare Redesign Collaborative 2007 Coalition of Leaders in Louisiana Healthcare 2007 Primary Care Access to Stabilization Grant 2008 Louisiana Health First 2010 Greater New Orleans Community Health Connection 2013 GNOCHC Extension History of Health Reform in Louisiana is Bipartisan

7. Community Health Centers

8. 2005 Hurricane Katrina and Levee Failures 2006 Louisiana Healthcare Redesign Collaborative 2007 Coalition of Leaders in Louisiana Healthcare 2007 Primary Care Access to Stabilization Grant 2008 Louisiana Health First 2010 Greater New Orleans Community Health Connection 2013 GNOCHC Extension History of Health Reform in Louisiana is Bipartisan

9.  291,000 uninsured adults in Louisiana below 138% FPL would gain comprehensive insurance (DHH and Legislative Fiscal Office - LFO)  Expected to bring nearly $16 billion in federal health care investment to the state over 10 years (KFF)  Would increase economic activity in Louisiana an additional $1.8 billion in 2016 alone (Families USA, 2013)  The federal government would cover 100% of cost for first 3 years and 94% of all costs Medicaid Maximization Impact Louisiana Legislative Fiscal Office, Fiscal Note ScenarioTake-Up RateSGF Savings, 10 yrs Low Impact75%$510 million High Impact95%$185 million

10. The Affordable Care Act: 3 Key Provisions 1.Insurance reforms: guaranteed issue, modified community rating, no pre-existing condition exclusions 2.Coverage expansion – through Medicaid, up to 138% FPL 3.Coverage expansion – through Private Health Insurance on the Marketplace ACA is financed through:  Medicare payment cuts  Disproportionate Share Hospital payment cuts

11. Calculating Premium Assistance: $9.00/hr part-time worker kff.org/interactive/subsidy- calculator KFF Premium Subsidy Calculator

12. Thank you. www.nola.gov/health kdesalvo@nola.gov