Consumer Health Coalition

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1 Consumer Health Coalition An overview of the Affordable Care Act and how to get health insurance through the marketplace Presented by Leslie Bachurski x200

2 Consumer Health Coalition Mission: To inspire a consumer movement to enhance access to quality, affordable health care in Southwestern Pennsylvania We accomplish this mission through: Outreach and Enrollment Education Advocacy / Community Organizing

3 What are we here to learn today? What is the Affordable Care Act or Obama Care? How does the law work? What is an insurance marketplace? When can someone enroll? How will I pay for insurance? What are tax subsidies and cost-sharing programs? How can I get help choosing the right plan for me or the cosumers I serve?

4 What is the Affordable Care Act (ACA)? Signed into law March 2010 to make health insurance more affordable and to level the playing field Law will help 48.6 million Americans who would otherwise not have health coverage In PA this accounts for 3 million families

5 How are we already benefitting from the ACA? Insurance companies can no longer deny children based on a pre-existing condition (and adults in 2014.) PA Fair Care put into place (6,960 individuals as of March 2013) (Now is a federal plan) Young adults up to age 26 can now stay on their parent s health plan (91,000 in PA) Insurance companies can no longer cancel your coverage due to becoming sick

6 No more lifetime caps (4,582,000 Individuals in PA) New appeal processes and external appeals will help to end insurer abuse Rate increases and premium hikes must be justified (80/20 rule) The donut hole for seniors will begin to close. In 2013, anyone reaching the Donut Hole will receive a 52.5% discount on brand-name formulary drugs and a 21% discount on all generic formulary medications.

7 Pennsylvania s Model PA will utilize the Federally Facilitated Marketplace Opens on October 1, 2013 Received 35 million to date to prepare for the changes (available 24 hours a day) TTY:

8 Health Insurance Marketplace What is an insurance exchange? -American Health Benefits Marketplace -Small Business Marketplace (SHOP) Which plans will be included? (Qualified Health Plans) -Minimum set of benefits standards Essential Health Benefits - Ambulatory, ER, hospital stays, maternity care, MH services, drug and alcohol rehabilitation, some medical equipment and supplies, lab tests, preventive care, prescription drugs

9 Who can purchase health insurance through the Insurance Market Place? A "qualified individual" is a U.S. citizen or legal immigrant who is a resident of the state that established the Exchange and who is not incarcerated at the time of enrollment.

10 Tax Credits and Cost-Sharing Consumer will pay a reduced rate if their total household income is between 100% 400% of the FPL Based on household income and family size Cost-sharing will help to reduce outof-pocket costs for individuals between % of FPL (Silver plans only)

11 2013 Federal Poverty Guidelines

12 Actuarial Value The ACA requires health plans offered through the marketplace to meet a particular value Bronze = 60% Silver = 70% Gold = 80% Platinum = 90%

13 Silver VS. Bronze CSR= Cost Sharing Reduction

14 Silver VS. Gold CSR= Cost Sharing Reduction

15 What if I already have coverage? Can I keep my insurance through my job or spouse (Employer will indicate the value/cost which will be given a minimum value standard) (60% AV and no more than 9.5% of income) Can I purchase insurance in the marketplace if it is cheaper? (Self-only coverage must be greater than 9.5 of household income) Can I keep my kids on Medical Assistance or CHIP?

16 Employee Coverage VS Marketplace Coverage

17 What if I go without health insurance? How will I be penalized? You are exempt from paying the penalty if you: Cannot afford the coverage (based on guidelines) Your household income falls below a certain threshold Experiencing a short gap in coverage Are part of certain religious sects (Amish, Mennonite) Are part of a health care sharing ministry (A cost sharing arrangement among persons of similar and sincerely held beliefs. HCSMs are not-for-profit religious organizations acting as a clearinghouse for those who have medical expenses and those who desire to share the burden of those medical expenses.) Are incarcerated Are not lawfully present in the USA Are a member of an Indian tribe Certain other categories of hardship that will be available through the tax filing process (TBD)

18 Penalty Fees for individuals $95 or 1% of taxable income (whichever is greater) in 2014 $325 or 2% of taxable income (whichever is greater) in 2015 $695 or 2.5% of taxable income (whichever is greater) in 2016

19 Penalty fees for large employers $ $3000 per employee -determined by size of the business -if No health plan is offered -if an employee receive a tax subsidy through the exchange because their coverage did not meet the 60% actuarial value or is over 9.5% of income

20 Enrollment process Online, Call center, by mail in paper application, or in person October 1, 2013 March 31, 2014 Coverage effective on January 1, 2014 (If enrolled by 12/15/13) Everyone is screened for Medical Assistance or CHIP Everyone is screened for tax credits - Tax credit automatically sent to insurance company - What if my salary changes, I have a baby, or get married? How will it affect my tax credit? (available 24 hours a day) TTY:

21 What you need to apply Social Security Number (or legal immigrant number) Employer and Income information (tax return, W-2s, paystubs) Policy Number for any current health insurance coverage (for those who are applying) A completed Employer Coverage Tool

22 Medicaid Expansion Primarily persons that do not currently qualify under MA guidelines Generally healthy adults under age 65 Below 133% (138%) of FPL - Includes standard 5% income disregard $15,232 for a family of one; $31,322 for a family of four would get MA Eliminates Asset Tests 650,000 Statewide If not expanded those making under 100% that are not eligible for MA would not receive any tax credits in 2014 (Hopefully 2015!) Fully paid for the first 3 years, then reduced to 90% in 2020

23 Consumer Health Coalition 415 East Ohio Street Suite 300 Pittsburgh, PA p f Thank you for attending and completing your evaluation

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