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2 Managing the Coverage Gap: Enrollment Resources for States without Medicaid Expansion Affordable Care Enrollment (ACE) TA Center November 17, 2014

3 ACE TA Center Objectives Provide tools and resources to help providers (grantees and subgrantees) enroll clients of color, always considering cultural and historical barriers to enrollment Build grantee understanding of the need for culturally competent O&E strategies Provide technical assistance and training to promote the use of these tools and resources Enhance the capacity of RWHAP Part A and B grantees to support subgrantees

4 How to Ask a Question Attendees are in listen-only mode. If you have a question, use the chat box at the lower-left of your screen to chat with the presenter. You may also questions to [email protected] after the webinar.

5 Can You Hear Us? The audio is being shared via your computer speakers/headset. If you can t hear the audio, make sure your computer audio is turned on. If you re still having problems, please use the following call-in number:

6 MIRA EMILY LAUREN Introductions

7 After today, we hope you will be able to: Identify challenges specific to grantees and providers in non-expansion states Describe care and coverage options for clients in the Medicaid coverage gap Learn about the enrollment successes of an AIDS Service Organization in a non-expansion state

8 Audience Poll Have you been on an ACE TA Center webinar before? Yes No

9 Audience Poll What is your role in your RWHAP funded agency? Program manager or staff Case Manager Clinical director or staff Benefits and enrollment staff Director or administrator Quality assurance/compliance staff Other (chat role to Chairperson) N/A (I'm not a grantee or provider)

10 Challenges Limited Resources

11 Challenges Limited Resources Confusing Guidance

12 Challenges Limited Resources Confusing Guidance Differing Landscapes

13 Community Catalyst Gives consumers a voice in health care reform Provides leadership and support to state and local consumer organizations, policymakers and foundations that are working to guarantee access to high-quality, affordable health care for everyone Catalyst for collaboration, innovation, and action in health care reform

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17 The Coverage Gap: There are nearly four million poor uninsured adults who will fall into the coverage gap. 25% in Texas 17% in Florida 9% in North Carolina 7% in Georgia

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19 HIV and the Coverage Gap: Disparities among those in the gap Kaiser Health News reported in March that nearly 115,000 uninsured, low-income people living with HIV/AIDS would be eligible for Medicaid if all states expanded Medicaid. Of that number, nearly 60,000 live in states not expanding Medicaid.

20 Rates of Persons Living with an HIV Diagnosis, by County, 2010 * Data are not shown to protect privacy. ** State health department requested not to release data. Note. Data include persons with a diagnosis of HIV infection, regardless of the stage of disease at diagnosis, and have been statistically adjusted to account for reporting delays and missing risk-factor information, but not for incomplete reporting. Data Source: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention.

21 Rates of Persons Living with an HIV Diagnosis by County, 2010 Current Status of Medicaid Expansion Decisions

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23 Use the chat box to submit your response to the presenter What are you doing to help clients obtain coverage?

24 Navigating new policies RWHAP ACA

25 Policy details are available on HAB s website at:

26 Coverage and Care Options for RWHAP Clients Medicaid CHIP Medicare State-funded HIV/AIDS Programs VA/Tricare or military health care Indian Health Services Community Health Centers RWHAP/ADAP Marketplace

27 Coverage and Care Options for RWHAP Clients 32% of ADAP clients in states that have not yet expanded Medicaid have an income above 138% FPL ADAP clients in non-expansion states, by income

28 Marketplace Plan Open Enrollment Timeline for 2015 Open Enrollment Timeline for 2015 Marketplace Coverage* * In state-based and partnership Marketplace states, RWHAP providers and case managers should check with their Marketplace or regulating agency on the redetermination and renewal process. ** Clients can review their plan benefits and change plans at any time during Open Enrollment. Clients who change plans must switch their coverage before December 15, 2014 to stay covered for January 1, *** Clients who are auto-enrolled will have no gap in coverage. Clients who are changing plans need to enroll by 12/15/14 to avoid any gap in coverage for plans beginning 1/1/15.

29 Enrollment: More than an application

30 targethiv.org/ace

31 Audience Poll What is the biggest challenge your clients face enrolling into health coverage programs? 1. Lack of information on the ACA 2. Unaware of the importance of health insurance 3. Plan options are not affordable 4. Plans do not include needed medications 5. Plans have a limited number of HIV providers 6. Other

32 ACE TA Center Tools & Resources Health Care Plan Selection Worksheet Common Questions & Suggested Responses for Engaging Clients in Health Coverage (also in Spanish) Plain Language Quick Reference Guide (also in Spanish) Eligibility Decision Tree

33 Marketplace Plan Renewal Flow Chart

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35 Recorded Webinar on ACE TA Center Resources What you need to know: Open Enrollment & Health Insurance Plan Renewals for 2015 Watch the webinar to learn more about: Insurance plan renewals for 2015 New ACE TA Center resources Challenges for enrolling clients for the first time Additional ACE TA Center resources that can help View recording at: targethiv.org/ace

36 ACA Implementation in Alabama

37 Alabama Landscape Enroll America: Uninsured in Alabama, July * Kaiser Family Foundation.

38 Enrollment Model: Partner with 6 ASOs around the state and have Navigators available to work with all persons, including those living with HIV/AIDS

39 Year One Outcomes 97,870 Alabamians enrolled in plan through Marketplace during open-enrollment 7,500 assisted by Enroll Alabama Thousands reached through presentations, community events, and more

40 Moving forward for PLWH Enrollment: about 17% of ADAP clients are eligible for subsidies through the marketplace = 305 people Medicaid: about 76% of ADAP clients would be eligible for Medicaid expansion = 1,300 people* * State Health Reform Modeling Report: Alabama. Harvard School of Law and Treatment Access Expansion Project

41 Challenges Coordinating a statewide program from one location Navigator training being so lengthy Stigma on ACA Medicaid Expansion messaging

42 Opportunities Each partner has their own network People all over want to help Relationship building

43 Successes People moving from ADAP to Marketplace Plans People who have never had insurance because pre-existing conditions and cost Andrew s story Huntsville Clinic

44 Plans for 2015 Coordinate with existing partners Toll-Free number for persons inquiring Radio and media spots

45 Additional helpful resources ACE TA Center Fact Sheet to help partners assist PLWH Recent federal Navigator grant awardees

46 Additional helpful resources State Health Insurance Marketplace Types, 2015

47 Questions

48 Upcoming webinar DEC. 4 Cost Sharing and Tax Credits: Making Health Insurance Affordable 3-4pm ET Coming in early 2015: webinars to support outreach to and enrollment of immigrant clients, and strategies for supporting diverse clients, including clients of color. Webinar recordings will be available at: targethiv.org/ace

49 Questions

50 Thank you for joining us! Please complete the evaluation! targethiv.org/ace Sign up for our mailing list, download tools and resources, and more Contact Us BISOLA MIRA STEWART TAJAN