TheAffordableCareAct intheInland Empire,CaliforniaandtheNation

LomaLindaUniversityInstituteforHealthPolicyandLeadership

April8,2014

AffordableCareAct(ACA)

InMarch2010,PresidentObamasignedintolawthe

AffordableCareAct.

NationalHealthReform– AReality

2

• CommunityResource

• California-Based,extensivetraveltoNV,AZ,andHIandsignificantworkwiththePacific

• Day-to-day,week-to-week,month-to-month

• Educatethepubliconthebenefitsofhealthcarereform

• TroubleshootingwithinHHSandotherFederalagencies/departments

OfficeoftheRegionalDirector

3

– ExpandingAccessandCoverage

– ImprovingQualityandLoweringCosts

– ConsumerProtections

FrameworkofHealthCareReform

4

• SinceOct.1st morethan7.1millionpeoplehaveenrolledinprivateinsurancethroughtheMarketplace.

• BetweenOctoberandFebruary,3millionadditionalpeopleenrolledMedicaidorCHIPand11.7millionweredeterminedeligibleforMedicaidorCHIP.

AffordableCareAct–ExpandingCoverage

5

• Slowestsustainednationalhealthspendinggrowthin50years– Lowgrowthcontinuedin2013forMedicareandMedicaid

– ResultinginNoIncreasein2014MedicarePartBPremium

• $1.6billionreturnedtoconsumersin2011and2012– Plansmustspend80%nowonhealthcare

• Rateincreasesfellfrom75%in2010to14%in2013• Over$15billionrecoveredfromanti-fraudefforts– arecordlevelwhichaddedyearstoMedicareTrustFund

AffordableCareAct–Accomplishments:QualityandCost

6

• The85percentofAmericanswhohaveinsurancehavemorechoicesandstrongercoveragethaneverbefore– 71MillionPeoplew/PrivateInsuranceGainedImprovedCoverageforPreventiveServices

– 105MillionAmericansNoLongerHaveLifetimeLimitsonTheirInsurance

• 3.1millionyoungadultswereabletostayontheirparents’healthinsuranceplansuntilage26

AffordableCareAct–Accomplishments:ConsumerProtection

7

• 1.2millionCalifornianshaveenrolledforhealthinsuranceandselectedplansthroughtheMarketplacethroughtheendofMarchandover1.9millionhavebeenfoundlikelyeligibleandenrolledforexpandedMedi- CalcoveragethroughMarch

• 435,000youngadultshavegainedinsurancethroughtheirparents’plans

• 358,862peoplewithMedicarethrough2013received$333millioninprescriptiondrugdiscounts

• 3.6millionpeoplewithMedicarereceivedafreepreventiveservice• 8millionprivatelyinsuredpeoplegainedimprovedcoveragefor

preventiveservices• 12millionCaliforniaresidentshavehadlifetimelimitsremovedfrom

theirinsurance

AffordableCareAct–CoverageAccomplishmentsinCalifornia

8

• FromOctoberThruFebruary72,340enrolledinInlandEmpirecountiesforsubsidizedandnon-subsidizedCoveredCaliforniahealthinsuranceplans.– 89%SubsidyEligible

• 110,721havebeendeterminedlikelyeligibleforMedi-Calinthetwo-countyarea.

InlandEmpireEnrollment

9

6. Prescriptiondrugs

7. Rehabilitativeandhabilitativeservicesanddevices

8. Laboratoryservices

9. Preventiveandwellnessservicesandchronicdiseasemanagement

10. Pediatricservices,includingoralandvisioncare

1. Ambulatorypatientservices

2. Emergencyservices

3. Hospitalization

4. Maternityandnewborncare

5. Mentalhealthandsubstanceusedisorderservices,includingbehavioralhealthtreatment

AllQualifiedHealthPlansWillCoverTheseEssentialHealthBenefits

10

• ElectedOfficials• Governments– Federal,State,Local,Tribal,Territorial,Pacific• Community-BasedOrganizations• Business/Employers• Labor• Providers• HealthPlans/Issuers• Faith-BasedOrganizations• Agents/Brokers• Academia• Philanthropy• Others

PartnershipsforImplementation

11

• YouCannotSeparatePolicyfromPolitics• RelationshipswithElectedOfficialsareMultifaceted• YouCannotTellSomeoneHowtoFeel• KnowYourRole:CoordinationandCollaborationvs.LeadingtheCharge

• TranslationofTechnicalInformation:It’sAllAboutCommunitiesEducatingCommunities

• ConnectivityandTroubleshooting:DoNotAssumeEveryoneKnowstheBasicsofGovernmentortheACA

PartnershipsforImplementation:LessonsLearned

12

AClearPathForward

NationalHealthReform– AReality

13

KenShapiroExecutiveOfficerKenneth.Shapiro@hhs.gov415-437-8501

StevenWiener(AZ,NV)RegionalOutreachSpecialistSteven.Wiener@hhs.gov415-437-8518

BonniePreston(CA,HI)RegionalOutreachSpecialistBonnie.Preston@hhs.gov415-437-8503

Thankyou!

HerbK.SchultzRegionalDirector,RegionIX(415)437-8500– Main(415)437-8502– Direct(415)265-7049– CellHerb.Schultz@hhs.gov

HHSWebsites:hhs.govHealthcare.govCuidadodesalud.gov

14