Health Reform 101Bringing the Affordable Care Act to Utah

Park City Community ForumDecember 2, 2013

Summit County’s marketplace

Medical Altius Health PlansArches BridgeSpanSelect Health

60 plans

4 plans18 plans

23 plans15 plans0 plans

Source: https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdfUtah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013)

60% 70% 80% 90%

Bronze Silver Gold Platinum

Costs for health plans will differ by metal tier

Higher PremiumsLower Premiums

Lower cost-sharingHigher cost-sharing

Catastrophic

<60%

And now we know the 2014 premiums…

Cheapest monthly premiums by age and plan level

Source: https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdfUtah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013)

Age in years

Rates apply to:• Single person• Summit County resident• Non-smoker

Summit County

And now we know the 2014 premiums…

Most expensive monthly premiums by age and plan level

Age in years

Rates apply to:• Single person• Summit County resident• Non-smoker

Source: https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdfUtah Individual on Exchange Rates - Medical Plans - Non-smoker Rates for plans currently approved (10/072013)

Summit County

Who will be helped?(in billions)

270,000 Utahns will be eligible for premium subsidies

[1] “Help is at Hand: Health Insurance Tax Credits for Utah,” Families USA, based on analysis by the Lewin Group, April 2013

Carbon, Daggett, Duchesne, Emery, Grand, Morgan, San Juan, Summit, Uintah, Wasatch

16,250

Who is eligible for premium subsidies?

Source: 2013 Federal Poverty Guidelines, Published in the Federal Register, January 24, 2013 http://healthpartnersamerica.com

A family of four can earn up to $94,200 a year and receive a premium subsidy

The Reyes FamilyIncome: $53,000Residence: Park City, UtahAges: Dad : 45 Mom: 42 Kids: 10, 13

Annual income: $53,000% of Poverty Level: 225%Expected family contribution: 7.18% of income

Yearly premium cost: $9,084 The Reyes’ contribution: $3,804 Subsidy received: $5,280

Monthly premium: $757 The Reyes pay: $317 per month Subsidy pays: $440 per month

Source: Kaiser Family Foundation Subsidy Calculator; http://kff.org/interactive/subsidy-calculator; Image source: CBPP

Benchmark Silver Plan

Annual income: $44,000% of Poverty Level: 225%Expected contribution: 7.19% of income

Yearly premium cost: $6,458 The Shumway’s contribution: $3,162 Subsidy received: $3,297

Monthly premium: $538 The Shumway’s pay: $263 per month Subsidy pays: $274 per month

Source: Kaiser Family Foundation Subsidy Calculator; http://kff.org/interactive/subsidy-calculator; Image source: JohnCropper

Benchmark Silver Plan

The ShumwaysIncome: $44,000Residence: Provo, UtahAges: Dad : 24 Mom: 23 Kid: On the way

Mr. and Mrs. SmithIncome: $42,000Residence: Roy, UtahAges: 60, 62

Annual income: $42,000% of Poverty Level: 271%Expected contribution 8.65% of income

Yearly premium cost: $10,698 The Smith’s contribution: $3,634 Subsidy received: $7,064

Monthly premium: $891 The Smiths pay: $303 per month Subsidy pays: $589 per month

Source: Kaiser Family Foundation Subsidy Calculator; http://kff.org/interactive/subsidy-calculator; Image source: Creative Commons

Benchmark Silver Plan

Find out how much you would pay…

www.kff.org

Kaiser Family Foundation - Premium Subsidy Calculator

$415

$156

$56 $114

How the ACA is funded: Cuts (in billions)Total: $741 billion

Medicare / Medicaidpayment rates

Medicare Advantage

Uncompensated care for hospitals (DSH) Other

[Chart] CBO / Washington Post Wonkblog http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/30/how-congress-paid-for-obamacare-in-two-charts//

[2013-2022]

How the ACA is funded: Taxes (in billions)

$55

$106

$111

$216

$318

$87

Penalties (individuals)

Penalties (employers)

‘Cadillac’ health plans

Cost-savings

High-earners capital gains taxes

Medical devices tax

Total: $893 billion

[Chart] CBO / Washington Post Wonkblog http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/30/how-congress-paid-for-obamacare-in-two-charts//

[2013-2022]

What are the penalties for remaining uninsured in 2014?

[Chart] Kaiser Family Foundation

$285 $975 $2,085

Starting in 2014

Navigators and Enrollment

Who are the helpers?Navigator

Certified Application Counselor

Experts trained to help others evaluate their insurance options on the new insurance marketplace.

www.healthcare.govCuidadoDeSalud.gov

Where can I get help?

www.takecareutah.org

Where can I get help?

Our trained counselors are ready to help you understand your new options to find affordable

health care coverage today

More resources are on the way…

Dial 2-1-1

Where can I get help?

United Way’s 2-1-1 information specialists are standing by to answer your health care questions

2-1-1

Community Health Clinics

Where can I get help?

Our health clinics can help you enroll in new insurance coverage for you and your family.

www.auch.orgAssociation of Utah Community Health

Insurance brokers

Where can I get help?

Many brokers are trained and certified to help individuals and businesses with enrollment

www.utah.gov/agent-search/search.html

www.utah.gov

What state agencies can do…

(in billions)

No one can be denied or priced out of

coverage for a pre-existing condition

(1) healthcare.gov

(2) Being sick doesn’t matter

anymore

(4) Subsidies will make premiums

more affordable

60%70%

80%90%

(3) It’s private insurance

(and it’s good insurance)(5) Navigators will

help you sign up

Call or email UHPP to schedule a presentation just like this one

Want to learn more?

Jason StevensonEducation and Communications Directorcell. 617-290-8188work. 801-433-2299 ext. 7stevenson@healthpolicyproject.org