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TRANSCRIPT
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KENTUCKY Cabinet for Health and Family Services
Health Policy in the Affordable Care Act Era
Emily Whelan Parento, JD, LLM Executive Director
Office of Health Policy
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KENTUCKY Cabinet for Health and Family Services
Presenta(on Overview
• Kynect, Kentucky’s Health Benefit Exchange
• Kyhealthnow, advancing our state of wellness
• Early Results from ACA Implementa(on
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Expanding Access to Coverage and Care for All Kentuckians
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Kentucky’s uninsured
640,000 are currently uninsured: • 300,000 may qualify for Medicaid under the new eligibility rules
• 290,000 may qualify for premium assistance through the Exchange
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Kentucky’s Uninsured • 640,000 esNmated uninsured prior to first open
enrollment period, approximately 17.5% of the populaNon under 65
• 308,000 potenNally eligible for Medicaid under the new rules
• 332,000 potenNally eligible for coverage through health benefit exchange
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How Did We Get Here? Impact In Kentucky
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Kentucky’s uninsured
640,000 are currently uninsured: • 300,000 may qualify for Medicaid under the new eligibility rules
• 290,000 may qualify for premium assistance through the Exchange
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Kentucky’s Under 65 Popula(on Uninsured By FPL
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
< 138% FPL 139%-‐399% FPL > 400% FPL
Source: Kaiser Family Founda3on, State Health Facts
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Kentucky’s uninsured
640,000 are currently uninsured: • 300,000 may qualify for Medicaid under the new eligibility rules
• 290,000 may qualify for premium assistance through the Exchange
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Kentucky’s Uninsured By Race/Ethnicity
16%
22%
38%
0%
5%
10%
15%
20%
25%
30%
35%
40%
White Black Hispanic
Rates of Uninsured by Race/Ethnicity
Source: Kaiser Family Founda3on, State Health Facts
White 77%
Black 10%
Hispanic 10%
Other 3%
Distribu(on of Uninsured by Race/Ethnicity
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Kentucky Health Benefit Exchange Governor Beshear signed an execuNve order which:
• Created the exchange and its administraNve structure
• Organized the exchange under Cabinet for Health and Family Services
• Established an Advisory Board
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Why a state-‐based exchange?
• Allows for flexibility, including determinaNons of Medicaid eligibility
• Kentucky’s unique economic, health and regional needs • Determine benefits provided in Kentucky’s exchange • Prevent dual regulaNon of the health insurance market, and • Integrate support from interested stakeholders.
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ENROLLMENT SUCCESS • In the first enrollment year, over 521,000 Kentuckians enrolled in coverage
via kynect, approximately 75% of whom were previously uninsured. • As of January 7, 2015, more than 114,000 individuals have enrolled via
kynect, including renewals and new purchases of QHPs, as well as those newly eligible for Medicaid.
• Reduc(on in the uninsured: Gallup Healthways (summer 2014) found that Kentucky’s uninsured rate dropped from 20.4% to 11.9% in the first half of 2014.
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How Did We Get Here? Before ACA
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How Did We Get Here? Aeer year 1 ACA
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text
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kyhealthnow
kyhealthnow 14
• Governor Beshear announced February 20, 2014 • 7 Statewide Health Goals for next 5 years
– Reduce Rate of Uninsured Individuals to < 5% – Reduce Smoking Rate by 10% – Reduce Obesity Rate by 10% – Reduce Cancer Deaths by 10% – Reduce Cardiovascular Deaths by 10% – Reduce % of Children with Untreated Dental Decay by
25% and Increase Adult Dental Visits by 10% – Reduce Deaths from Drug Overdose by 25% and
Reduce the Average # of Poor Mental Days of Kentuckians by 25%
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kyhealthnow 15
• Building on the Affordable Care Act – Enrollment in QHPs and Medicaid – Capitalizing on Preventive Services and EHB
• Creating a Long-Term Investment in Kentucky’s Future – Tackling the Major Drivers of Poor Health in Kentucky – Comprehensive Approach to Reduction in Uninsured,
Tobacco Use and Obesity • Health In All Policies
– All of Government Represented in kyhealthnow – Multi-Stakeholder Engagement
kyhealthnow
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kyhealthnow 16
kyhealthnow Representative Strategies: Tobacco
• Support for comprehensive state-wide smokefree legislation • Support an increase in tobacco tax • Regulation and taxation of e-cigarettes on par with other
tobacco products • Support legislation banning sale of e-cigarettes to minors • Expansion of tobacco free policies to more executive branch
property • Challenge more school districts to adopt 100% tobacco free
property policies • Increase use of smoking cessation therapy by 50% in 5
years
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kyhealthnow 17
kyhealthnow Representative Strategies: Obesity
• State employee plan coverage for Diabetes Prevention Program • Work toward implementing healthier vending and concessions on
executive branch property • More than $30 million in federal funds directed toward pedestrian
and bike paths by end of 2015 • 10 New Trail Towns Certified by end of 2015 • School-based strategies such as support for BMI reporting and
increased physical activity • Engagement with the employer community through development
of initiatives to honor and recognize employers supporting increased physical activity.
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kyhealthnow 18
ACA: Early Results • Updated whitepaper re impact of Medicaid expansion to be
released soon – 5300 health care jobs Nov 2013-Nov 2014, with accelerating pace – Thousands more administrative and support positions – Hospitals have received $450 million increase in Medicaid revenue,
which includes only 9 months of expansion payments – Total infusion of approximately $1 billion into Kentucky in 2014 from
Medicaid expansion
• Health impacts: – In Emergency Rooms, 78% drop in charity care, 51% drop in self-pay – Dramatic increase in use of preventive services, such as cancer
screenings and immunizations – Significant increase in utilization of behavioral health & substance use
treatment
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Advancing Our State of Wellness
kynect +
kyhealthnow =
A Healthier, More Economically Competitive Kentucky