THCC MTMHI Training

Tennessee Health Care Campaign

Brad A. Palmertree, BSWTennessee Health Care Campaign

The New Health Insurance Marketplace: The Impact of Health

Reform in Tennessee


Public Policy

Advocacy

Grass-roots

Direct Servic

e

Tennessee Health Care CampaignWorking for affordable access to high-quality

health care for all Tennesseans

2


Affo

rdab

ility

Health Reform

Gua

rant

eed

Cov

erag

e

Shared R

esponsibility

3

Tennessee Health Care Campaign4


Well….

kinda


Unpacking the Affordable Care Act

Essential Health Benefits

Donut Hole

Primary Care

Young Adults

Pre-Existing Conditions Eliminated

OBAMACARE

Medicaid Expansion

Premium Subsidies

Lifetime & Annual Caps Eliminated

80/20 Rule

OBAMACARE

HANDLE WITH

CARE

Small Business Tax Credits

6


Prevention & Wellness

Alcohol Misuse

Depression

Immunizations

Diet Counseling

Type 2 Diabetes

Blood Pressure

Obesity

Cholesterol

HIVTobacco Use

STI Prevention

Well Baby/Child Visits

7

Bonus: Calorie Counts on Menus


Prevention & Wellnessfor the ladies

STI Counseling

OB/GYN w/o referral

Gestational DiabetesScreening

BreastfeedingSupport & Supplies

Contraception & Contraceptive Counseling

HIV Screening & Counseling

Cervical CancerScreening

HPV DNA Testing

Well-Woman VisitsBreast Cancer Mammography &Chemoprevention

Domestic ViolenceScreening & Counseling

8


Coming Up

Insurance MarketplaceTENNCARE EXPANSION*

9


FPL

400%

300%

200%

100%

Children (CoverKids)

Undocumented Immigrants

Adults w/o Children

People with Disabilities

ParentsPregnant Women

0% 0%

■ Medicaid and CHIP (Tennessee 2012 eligibility levels)■ Uninsured or insured via other coverage source

Insurance Marketplace Subsidized

Unsubsidized

2014138% Medicaid Expansion 126%

75%

Linking Tennesseans to Coverage (2014)

185%

250%

138%

10


Small Businesses

Individuals & Families

IRSSSAINS

Qualified Health Plans

SHOP Qualified Health Plans

SHOP Marketplace

Federal Insurance Marketplace

11

http://www.covertn.gov/web/cover_kids.html


Easy Shopping Experience

• Easy-to-read format• Glossary of terms

(deductible, co-pay, etc)

• Costs & benefits in plain English on two sheets of paper

12


The “IF”

Factor14


POLITICIAN

S

15


The Politics“For the last several months, I’ve been working toward a ‘Tennessee Plan’ for health reform to change the way health care coverage looks in Tennessee. … The plan would include co-pays for those that can afford to pay something, so the user has some skin in the game when it comes to health care incentives. We would work with providers to lower the cost of care and to move from a model of paying for every service regardless of the result, to a payment method that is based on outcomes and quality care. Our plan would have a definitive circuit-breaker or sunset that could only be renewed with the General Assembly’s approval based on when the amount of the federal funding decreases.”

- Gov. Bill Haslam, 3/27/2013

Gov. Scott, FloridaGov. Sandoval, NevadaGov. Martinez, New MexicoGov. Kasich, OhioGov. Christie, New JerseyGov. Brewer, ArizonaGov. Tomblin, W. VirginiaGov. Dayton, MinnesotaGov. Snyder, MichiganGov. Dalrymple, N. Dakota


The Opportunity in Tennessee

Sources: Kaiser Commission on Medicaid and the Uninsured, Urban Institute, projections based on Census Bureau’s 2010

and 2011 Current Population Survey

Federal Poverty

Level0 - 138%

100% – 138%

139% – 399% > 400% Total

Number of Uninsured

547,476 145,819 329,922 50,319 927,717

Coverage Option

under ACATennCare*

TennCare* or

Marketplace

Marketplace with tax

credits/subsidies

Marketplace with no credits

*If Tennessee chooses to expand Medicaid

17


Questions?

Comments?

Violent Dissent?

THCC MTMHI Training

Healthcare

Transcript of THCC MTMHI Training