Affordable Care Act (ACA)...• 1.2 million Californians have enrolled for health insurance and...
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The Affordable Care Act in the Inland Empire, California and the Nation Loma Linda University Institute for Health Policy and Leadership April 8, 2014 Affordable Care Act (ACA)
Transcript of Affordable Care Act (ACA)...• 1.2 million Californians have enrolled for health insurance and...
TheAffordableCareAct intheInland Empire,CaliforniaandtheNation
LomaLindaUniversityInstituteforHealthPolicyandLeadership
April8,2014
AffordableCareAct(ACA)
InMarch2010,PresidentObamasignedintolawthe
AffordableCareAct.
NationalHealthReform– AReality
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• CommunityResource
• California-Based,extensivetraveltoNV,AZ,andHIandsignificantworkwiththePacific
• Day-to-day,week-to-week,month-to-month
• Educatethepubliconthebenefitsofhealthcarereform
• TroubleshootingwithinHHSandotherFederalagencies/departments
OfficeoftheRegionalDirector
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– ExpandingAccessandCoverage
– ImprovingQualityandLoweringCosts
– ConsumerProtections
FrameworkofHealthCareReform
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• SinceOct.1st morethan7.1millionpeoplehaveenrolledinprivateinsurancethroughtheMarketplace.
• BetweenOctoberandFebruary,3millionadditionalpeopleenrolledMedicaidorCHIPand11.7millionweredeterminedeligibleforMedicaidorCHIP.
AffordableCareAct–ExpandingCoverage
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• Slowestsustainednationalhealthspendinggrowthin50years– Lowgrowthcontinuedin2013forMedicareandMedicaid
– ResultinginNoIncreasein2014MedicarePartBPremium
• $1.6billionreturnedtoconsumersin2011and2012– Plansmustspend80%nowonhealthcare
• Rateincreasesfellfrom75%in2010to14%in2013• Over$15billionrecoveredfromanti-fraudefforts– arecordlevelwhichaddedyearstoMedicareTrustFund
AffordableCareAct–Accomplishments:QualityandCost
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• The85percentofAmericanswhohaveinsurancehavemorechoicesandstrongercoveragethaneverbefore– 71MillionPeoplew/PrivateInsuranceGainedImprovedCoverageforPreventiveServices
– 105MillionAmericansNoLongerHaveLifetimeLimitsonTheirInsurance
• 3.1millionyoungadultswereabletostayontheirparents’healthinsuranceplansuntilage26
AffordableCareAct–Accomplishments:ConsumerProtection
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• 1.2millionCalifornianshaveenrolledforhealthinsuranceandselectedplansthroughtheMarketplacethroughtheendofMarchandover1.9millionhavebeenfoundlikelyeligibleandenrolledforexpandedMedi- CalcoveragethroughMarch
• 435,000youngadultshavegainedinsurancethroughtheirparents’plans
• 358,862peoplewithMedicarethrough2013received$333millioninprescriptiondrugdiscounts
• 3.6millionpeoplewithMedicarereceivedafreepreventiveservice• 8millionprivatelyinsuredpeoplegainedimprovedcoveragefor
preventiveservices• 12millionCaliforniaresidentshavehadlifetimelimitsremovedfrom
theirinsurance
AffordableCareAct–CoverageAccomplishmentsinCalifornia
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• FromOctoberThruFebruary72,340enrolledinInlandEmpirecountiesforsubsidizedandnon-subsidizedCoveredCaliforniahealthinsuranceplans.– 89%SubsidyEligible
• 110,721havebeendeterminedlikelyeligibleforMedi-Calinthetwo-countyarea.
InlandEmpireEnrollment
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6. Prescriptiondrugs
7. Rehabilitativeandhabilitativeservicesanddevices
8. Laboratoryservices
9. Preventiveandwellnessservicesandchronicdiseasemanagement
10. Pediatricservices,includingoralandvisioncare
1. Ambulatorypatientservices
2. Emergencyservices
3. Hospitalization
4. Maternityandnewborncare
5. Mentalhealthandsubstanceusedisorderservices,includingbehavioralhealthtreatment
AllQualifiedHealthPlansWillCoverTheseEssentialHealthBenefits
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• ElectedOfficials• Governments– Federal,State,Local,Tribal,Territorial,Pacific• Community-BasedOrganizations• Business/Employers• Labor• Providers• HealthPlans/Issuers• Faith-BasedOrganizations• Agents/Brokers• Academia• Philanthropy• Others
PartnershipsforImplementation
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• YouCannotSeparatePolicyfromPolitics• RelationshipswithElectedOfficialsareMultifaceted• YouCannotTellSomeoneHowtoFeel• KnowYourRole:CoordinationandCollaborationvs.LeadingtheCharge
• TranslationofTechnicalInformation:It’sAllAboutCommunitiesEducatingCommunities
• ConnectivityandTroubleshooting:DoNotAssumeEveryoneKnowstheBasicsofGovernmentortheACA
PartnershipsforImplementation:LessonsLearned
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AClearPathForward
NationalHealthReform– AReality
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StevenWiener(AZ,NV)[email protected]
BonniePreston(CA,HI)[email protected]
Thankyou!
HerbK.SchultzRegionalDirector,RegionIX(415)437-8500– Main(415)437-8502– Direct(415)265-7049– [email protected]
HHSWebsites:hhs.govHealthcare.govCuidadodesalud.gov
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