1. Advocacy Opportunities to Promote Health Equity in Health Care Reform Implementation Kara D. Ryan, MPP Research Analyst, Health Policy Project National Council of La Raza (NCLR) From Vision to Reality: State Strategies for Health Reform Implementation November 12, 2010

2. Overview Promoting Wellness for Health Disparities Populations & Underserved Communities Improving Access to Care for Immigrant and Mixed-Status Families Improving Health Care Access and Quality for Limited English Proficient (LEP) populations

3. Promoting Health & Wellness Clinical prevention and public health No cost-sharing for preventive services rated A or B Support for disease-based prevention and chronic disease management Environment and systems change Promote wellness for underserved communities Address upstream factors and social determinants of health

4. Community Transformation Grants Origins and Objectives Funding and Administration Targeting Underserved Communities

5. Community Transformation Grants Science- Informed Innovation Evidence-Based Integration of Community Demonstrate Effectiveness Target specific disease Adequate Time to Show Change Address Upstream Factors

6. Access to Health Care for Immigrant Families Undocumented immigrants excluded from exchanges Layers of citizenship or legal status verification imposed Will impact mixed-status families Five-year bar to Medicaid not lifted for legal immigrants

7. Access to Health Care for Immigrant Families Outreach & enrollment to eligible family members Preserve child-only plans Streamline verification Promote access to alternative paths to care Remove exclusion and five-year bar

8. Improving Health Care Access and Quality for LEP Populations In § 1557, prohibits discrimination (race, national origin (incl. language), gender, age or disability). Applies to activities and programs receiving federal funds or administered by Agency or entity created by the legislation Should apply to exchanges and qualified health plans

9. Improving Health Care Access and Quality for LEP Populations Language access advocacy Outreach & enrollment Plan marketing & definitions Web portals and HIT Covered benefits Provided services Stake- holder Input

10. Questions? Thanks! Kara D. Ryan Health Policy Research Analyst Office of Research, Advocacy, and Legislation National Council of La Raza (NCLR) kryan@nclr.org Direct: 202.776.1703