presented by deb polun director of government affairs/media relations community health center...
TRANSCRIPT
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The Affordable Care Act:Implications for the
Health Care Landscape
Presented by Deb PolunDirector of Government Affairs/Media Relations
Community Health Center Association of Connecticut
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First…a bit about
Federally-Qualified Health Centers (FQHCs)
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BackgroundWhat is a community health center?
Also called “federally qualified health centers,” they provide medical, dental and behavioral health
services to people regardless of ability to pay.
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BackgroundCommunity health centers also provide “enabling services,” such as transportation,translation and referrals to specialists.
They are recognized and partially funded by the federal government. State governments also provide additional funding.
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BackgroundCommunity health centers are located in urban and rural areas across the country.
Nationally in 2012:» 1159 community health centers (8500+ sites)» 21 million patients
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Background
14 separate health centers
Over 200 sites
Over 340,000 patients
Over 1.6 million visits
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BackgroundIn Connecticut:
» 58% of patients are on Medicaid» 23% are uninsured» About 6% are on Medicare» 29% are best served in a language other
than English
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»Why did the federal government think we needed health reform?
Patient Protection and Affordable Care Act
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The ACA is aimed at:
» Improving the health of Americans» Integrating health care» Controlling health care costs
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» Signed into law on March 23, 2010» Immediately challenged by a number of
states and the National Federation of Independent Business
Patient Protection and Affordable Care Act
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Patient Protection and Affordable Care Act» US Supreme Court consolidated cases
and ruled most provisions constitutional on June 28, 2012
» Since its enactment, the US House of Representatives has made 42 efforts to repeal its enactment
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Highlights of the ACA
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Individual Mandate » All individuals must have a certain level
of health insurance coverage or else pay a fee˃Effective 2014˃Penalty in 2014 is $95/year or 1% of
income, whichever is greater.
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Provisions will be put into place to make the purchase of health insurance easier and more affordable:» Changes to commercial insurance» Help from employers » Expansion of Medicaid
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Provisions will be put into place to make the purchase of health insurance easier and more affordable:» Help from the government» Establishment of insurance marketplaces
(“Exchanges”)
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Commercial Insurance Provisions:» Young adults up to age 26 can be
carried on their parents’ insurance plans (2010).
» Individuals with pre-existing conditions will not be denied coverage or charged extra (kids: 2010; adults: 2014).
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Commercial Insurance Provisions:» Insurance companies cannot cancel
coverage just because the enrollee gets sick (2010).
» Preventive care, such as vaccinations and screenings, will be covered (2010).
»Women cannot be charged more than men (2014).
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Commercial Insurance Provisions:» 80-85% of premium dollars have to go
to health care – or they must refund the extra (2011).
» Lifetime limits will be eliminated (started in 2010, full implementation in 2014).
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Impact on Employers:» Large employers will be required to
either cover their workers or pay a fine (originally 2014, now delayed to 2015).
» Small businesses will not be required to provide coverage to their employees, but if they do, they can receive a tax credit (2010).
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Changes to Medicaid:» States can expand
Medicaid to all individuals up to 138% of FPL (2010).
» CT has decided to expand Medicaid (HUSKY D).
For a single adult,
annual income
limits will go from
~$6093 to
~$15,202. This
will capture
~40,000 people.
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Help from the Government:
» Individuals and families may qualify for assistance from the federal government in purchasing health insurance (2014).
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Health Insurance Exchange:» CT is setting up a state health insurance
exchange, which will be a marketplace for individuals and families to purchase health insurance (2014).
OCTOBER 1, 2013
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Changes to Medicare: » Preventive care is now included, including
an annual wellness visit (2011). » Additional help with prescriptions has
been added and the donut hole will be closed by 2015.
» New initiatives focus on community-based care, transitions from hospitals (2011).
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Impact on Health Centers (Nationally):$11 Billion in new health center funding over 5 years» New health centers» Expanded capacity» Infrastructure improvements
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Impact on Health Centers:
$1.5 Billion to National Health Service Corps to help place primary care providers in shortage areas. This includes every federally-qualified health center!
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Impact on Health Centers:$150 Million to all 330-funded FQHCs to assist with outreach and enrollment for the Exchanges» Almost $1.6M for CT health centers» 72 Certified Application Counselors
(CACs) currently doing enrolling at health centers; 39 additional will be online within a few weeks.
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Questions?