Melissa Stafford JonesHHS Regional Director, Region IX

Health Insurance Literacy Summit

September 25, 2015

Helping Consumers Understand Health Insurance:

Why is Health Insurance Coverage Important

Helping Consumers Understand Health Insurance:

Why is Health Insurance Coverage Important

Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, and Republic of Palau

Focus:Regional staff are the connection between regional stakeholders and the Department. There are Outreach & Education Professionals, Program &Project Officers, Caseworkers, Inspectors, and Auditors, who understand the region, its people, its cultures, and its needs.

Representation:• Administration for Children and Families• Administration for Community Living• Assistant Secretary for Preparedness and Response• Agency for Toxic Substances Disease Registry• Centers for Disease Control and Prevention• Centers for Medicare and Medicaid Services• Food and Drug Administration• Health Resources Services Administration• Indian Health Service• Office of the Assistant Secretary for Health• Office of Civil Rights• Office of the Inspector General• Substance Abuse and Mental Health Services Administration

Region IXThe U.S. Department of Health and Human Services

Region IXThe U.S. Department of Health and Human Services

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Today’s Topics Today’s Topics

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Rates of Coverage and Coverage Expansion The Value of Coverage Disparities Preventive Services Enrollment Periods Connecting Consumers to their Care

FRAMEWORK FOR MEASURING IMPACT OF THE AFFORDABLE CARE ACT

FRAMEWORK FOR MEASURING IMPACT OF THE AFFORDABLE CARE ACT

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Affordability

Access

Quality

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Increases in CoverageIncreases in Coverage

• Nationally, the percentage of people uninsured for 2014 was 10.4 percent, or 33 million people.

This was a decrease of 2.9 percentage points from the previous year.

• Arizona’s rate dropped to 13.6% in 2014, down from 17.1 percent in 2013.

• Insured people are more likely to have chronic conditions diagnosed.

• Insured people with a diagnosis are more likely to have their disease under control.

Disease Diagnosis and ControlDisease Diagnosis and Control

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• Leading Causes of Illness and Death among Hispanics: – heart disease– cancer– unintentional injuries

(accidents) – stroke– diabetes

• Other Health Risk Factors: – Asthma– chronic obstructive

pulmonary disease– HIV/AIDS– Obesity– Suicide– liver disease

Latino Health Disparities Latino Health Disparities

Latinos suffer from certain illnesses at higher rates than non-Hispanic white Americans

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• Uninsured rate – Hispanics = 33% (one of three)– Whites = 14% (one of seven)

• Low-income Hispanics are less well off on key measures of access to health care in states that have not expanded Medicaid

• Having health insurance reduces racial and ethnic disparities

Medicaid Expansion – Reducing Disparities

Medicaid Expansion – Reducing Disparities

• The maximum out-of-pocket cost limit for any individual Marketplace plan cannot be more than $6,600 for an individual and $13,200 for a family.

• Group health plans are prohibited from imposing lifetime limits on the dollar value of essential health benefits offered under the plan or coverage.

The Value of Health Coverage:Financial Security

The Value of Health Coverage:Financial Security

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In 2015, uninsured consumers will pay the higher of these two amounts:

• 2% of their yearly household income.

• $325 per person for the year ($162.50 per child under 18).

And…they won’t have coverage!

The Cost of Not Having Health Coverage

The Cost of Not Having Health Coverage

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• Plans provide free preventive care, without charging you a copayment or coinsurance. This is true even if the consumer hasn’t met their

yearly deductible.• These services include routine health care such as:

Preventive ServicesPreventive Services

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screenings check-upspatient counseling to

prevent illnesses disease, or other health problems

flu and pneumonia shots

vaccinesmammogramsdepression/behavioral

health screeningsblood pressure tests

Open Enrollment for healthcare.gov is November 1, 2015 – January 31, 2016.

Special Enrollment Period

Medicaid (AHCCCS) enrollment is always open.

Enrollment PeriodsEnrollment Periods

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• White House/HHS/Surgeon General Healthy Self Initiative– Building on coverage gains to build health– Emphasizing primary care and preventive services, individual health and wellness, and

community health• Health Insurance Literacy

– Department of Education report showed 1 in 10 Americans have proficient level of “health literacy”

– Language and cultural barriers add to confusion– Patients with low health literacy are more likely to be hospitalized and have more ER

visits– Goal of helping people understand health insurance and how to use it

• Connecting to Needed Health Services – Knowing how to utilize the health system– Ongoing Primary Care and Prevention– Chronic Care Management

Coverage to Care Resources

https://marketplace.cms.gov/technical-assistance-resources/c2c.html

Coverage to Care to... HEALTHCoverage to Care to... HEALTH

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Melissa Stafford JonesRegional DirectorHHS, Region IX415-437-8500Melissa.StaffordJones@hhs.gov@HHSRegion9

Thank you!Thank you!