Massachusetts US Census Bureau 2011

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Barnaby Dawson
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1 Massachusetts US Census Bureau 2011 Population: 6,587,536 Average persons per household: 2.48 Female persons: 51.6% Persons under 18: 21.3% Caucasian: 84.1% African American: 7.8% Asian: 5.6% Latino: 9.9%

2 Romneycare, MA Health Reform: Key Components Individual Mandate All adults in the state are required to purchase health insurance or face a financial penalty of up to 50% of the lowest cost premium Commonwealth Health Insurance Connector Administers subsidized and non-subsidized private health insurance; sets premium subsidy levels for Commonwealth Care; defines affordability for purposes of individual mandate Commonwealth Care Health Insurance Program Sliding-scale subsidized health coverage for individuals with incomes below 300% of the Federal Poverty Line (FPL); designed for income-eligible MA adult residents who are not otherwise eligible for Medicaid, who do not work, or work for employers who do not offer insurance Commonwealth Choice Health Insurance Program Non-subsidized coverage that meets certain coverage and cost standards Insurance Market Reforms Reforms to the private insurance market whereby insurers have to issue plans to any eligible applicant regardless of health status, and community rating MassHealth Expansion Expansion of state s Medicaid and Children s Health Insurance Program (CHIP), raising of enrollment caps on existing Medicaid programs for adults Employer Requirements Employers with 11 or more employees must contribute toward health insurance coverage for employees or pay a Fair Share contribution up to $295 annually per employee

individual mandate Commonwealth Care Health Insurance Program Sliding-scale subsidized health coverage for individuals with incomes below 300% of the Federal Poverty Line (FPL); designed for

3 Obamacare, Patient Protection and Affordable Care Act: Key Components Individual mandate Requires that all individuals not covered by an employer-sponsored health plan, Medicaid, Medicare, or public insurance, purchase and comply with an approved private insurance policy (with exemptions for religious reasons) Funded by broadened Medicare tax on incomes over $200,000 and $250,000 (for individual and joint filers, respectively), an annual fee on insurance providers, a 40% excise tax on costly insurance plans ( Cadillac plans) Health insurance exchanges A marketplace where individuals and small businesses can compare policies and premiums, and buy insurance (with government subsidy, if eligible) Medicaid Expansion Eligibility will be expanded to include all individuals and families with incomes up to 133% of the FPL; in states that choose to reject expansion, individuals and families at or below 133% of the FPL, but above their state s existing threshold, will not be eligible for coverage Sliding scale Low income individuals and families from 100%-400% of the FPL will receive federal subsidies on a sliding scale if they choose to purchase insurance via an exchange Guaranteed issue Requires policies to be issued regardless of any medical condition Restructuring of Medicare reimbursement From Fee-for-Service to Bundled Payments

and joint filers, respectively), an annual fee on insurance providers, a 40% excise tax on costly insurance plans ( Cadillac plans) Health insurance exchanges A marketplace where individuals and

4 Romneycare Obamacare Enacted in 2006 Funded by Medicaid (state appropriated 1115 Medicaid waiver for $26.75 billion over 3 years) Commonwealth Health Insurance Connector Provides free health care insurance for residents earning less than 150% of the federal poverty level Individual mandate Insurance market reforms Federal subsidies on a sliding scale Enacted in 2010 Funded by broadened Medicare tax on incomes over $200,000 and $250,000 (for individual and joint filers, respectively), an annual fee on insurance providers, a 40% excise tax on costly insurance plans ( Cadillac plans) Health insurance exchanges Low income individuals and families above 100% and up to 400% of the FPL will receive federal subsidies on a sliding scale

mandate Insurance market reforms Federal subsidies on a sliding scale Enacted in 2010 Funded by broadened Medicare tax on incomes over $200,000 and $250,000 (for individual and joint

5 Partnerships Dean s Beans Tapestry Health and Dean s Beans teamed up to create a new blend of coffee Tapestry EC Roast (Emergency Caffeine). Sales support Tapestry as well as the Women s Development Committee of the Pangoa Coffee Cooperative in Peru. Herrell s Ice Cream This local ice cream parlor offers a new flavor, Tapestry of Chocolate. Proceeds go directly to Tapestry Health.

Sales support Tapestry as well as the Women s Development Committee of the Pangoa Coffee

6 Client Insurance Enrollment Process

National Healthcare Reform: Implications for Nursing Education and Practice

National Healthcare Reform: Implications for Nursing Education and Practice UMass Graduate School of Nursing Alumni Association Program June 4, 2010 Katharine London 2 Goals for Today s Presentation Explain