1. 1 The Road to Affordable Care The Affordable Care Act – implementation, questions, opportunities, challenges

2. 2 How they want to feel is confident, informed, secure, satisfied, and in control. If you had to look for health insurance now, what feelings do you think you would have? Public: Past Confusion and Lack of Trust Poll: 42% of Americans unsure if Obamacare is still law By Sarah Kliff Washington Post| April 30, 2013 Source: Enroll America Research, November 2012

3. Limited Public Awareness The majority of uninsured Americans don’t know the health reform law will help them. 75% Three out of four of the newly eligible want in-person assistance to learn about and enroll in coverage. 3 Source: Enroll America Research, November 2012 78%

4. Affordable Care Act Positive Changes Preventive care at no charge Restrictions on annual spending caps No lifetime dollar limits on plans Dependent children covered to age 26 No pre-ex waiting periods under age 19 Childhood immunizations and adult vaccinations at no charge Effective 2010

5. No annual coverage limits on health plans No Pre-Existing Condition Waiting Periods for all For adults as well as children Requires “guarantee issue” and renewability of health insurance regardless of health status Change to Employer’s eligibility requirements – the wait can be no more than 90 calendar days from date of hire Effective 2014 Affordable Care Act Positive Changes

6. The leading perceived benefit of coverage across populations Financial Security & Peace of Mind A key message for women Prevention Resonated most with men and young adults in some states Protection from Financial Ruin or Injury Resonated with African Americans, Latinos, and Medicaid eligible Access To Care Key message for low income, Medicaid eligible Low cost or free health insurance coverage Messages that Resonate with the Public

7. Will people be able to compare plans? Will people select the right plan? Financial Security & Peace of Mind Will people understand their benefits? Will people access preventative services? Prevention Will the exchange be easy to understand? Will people get into Medicaid if eligible? Protection from Financial Ruin or Injury Will coverage be more than just a card? Will the public’s experience be heard? Access To Care Will coverage be affordable? Will services and Rx be affordable? Low cost or free health insurance coverage Moving from Messages to Reality

8. 8 or “Welcome Door”: What will it look like?

9. Source: February 2013 CBO estimates Millions Enroll at least 15 million people in new coverage options } 7 million in Exchange coverage 8 million in Medicaid or CHIP } 9 The 2014 Enrollment Opportunity: USA

10. Washington 2014 Enrollment Targets Enroll over ½ a million people in new coverage options } 280,000 in Exchange coverage 350,000 in Medicaid or CHIP } 10

11. Federal Basic Health Option

12. Vision for Exchanges A easy shopping experience Allow consumers to find and compare Qualified Health Plans (QHPs) on quality and cost Give consumers clear and easy-to-navigate information about coverage options – Apples : Apples Help consumers choose the best providers as well as health plans, based on what matters to them Drive delivery system and payment reforms Ultimately enroll consumers in the plan that will deliver the highest quality, highest value care that best meets their needs 12

13. FPL: Eligibility for Exchange Subsidy

14. Premium Subsidy: Your Premium Share is a Percent of Income Up to 133% FPL2% of income 133-150% FPL3 – 4% of income 150-200% FPL4 – 6.3% of income 200-250% FPL6.3 – 8.05% of income 250-300% FPL8.05 – 9.5% of income 300-400% FPL9.5% of income

15. Annual Out-of-Pocket Maximums: 100% FPL$1,983 OOP max/individual 200% FPL$2,975 OOP max/individual 300% FPL$3,967 OOP max/individual > 400% FPL$5,950 max/individual 15 In Addition to Premium Subsidies, Cost-Sharing Assistance is needed: Cost Sharing Subsidies 100-150% FPL94% Actuarial Value 150-200% FPL87% Actuarial Value 200-250% FPL73% Actuarial Value

16. 16 Consumers are confused by cost-sharing terms Who knows what these terms mean: deductible coinsurance benefit maximum allowed amount out-of-pocket max Selecting the right plan matters – Platinum, Gold, Silver, Bronze

17. Coverage is Here slide 17

18. A New Way to Enroll in Coverage Consumers can connect to whichever program they are eligible for, no matter where they start. 18 Complete single application Determine eligibility Enrolled in correct program! Medicaid CHIP In-Person Assistance Exchange Single Application

19. Going Forward: What will be seen, learned and evaluated? Will consumers come to the door and get in? Will there be true access to care? Will consumers get the “right” plan? Feedback – learn from experiences Don’t delay – if we don’t get it right the first time then we are going to lose trust, and lose the ability to cover uninsured 19 Covering the Uninsured