Health Insurance Exchange Implementation Implications for Pennsylvania Dave Chandra Senior Policy Analyst Center on Budget and Policy Priorities April 30, 2012 1
Linking Americans to Coverage (2014) FPL 400% 300% 200% 133% 185% 100% 100% 46% 0% 0% Children Pregnant Women Parents People with Disabilities Adults w/o Children Undocumented Immigrants Medicaid and CHIP (Pennsylvania 2012 eligibility levels) Uninsured or insured via other coverage source 2 2
Linking Americans to Coverage (2014) FPL 400% 300% 185% 200% 133% 133% 133% Medicaid Expansion 100% 2014 100% 46% 0% 0% Children Pregnant Women Parents People with Disabilities Adults w/o Children Undocumented Immigrants Medicaid and CHIP (Pennsylvania 2012 eligibility levels) Uninsured or insured via other coverage source 2 2
Linking Americans to Coverage (2014) FPL 400% Exchange 300% 185% 200% 133% 133% 133% Medicaid Expansion 100% 2014 100% 46% 0% 0% Children Pregnant Women Parents People with Disabilities Adults w/o Children Undocumented Immigrants Medicaid and CHIP (Pennsylvania 2012 eligibility levels) Uninsured or insured via other coverage source 2 2
Linking Americans to Coverage (2014) FPL 400% Exchange 300% Subsidize d 185% 200% 133% 133% 133% Medicaid Expansion 100% 2014 100% 46% 0% 0% Children Pregnant Women Parents People with Disabilities Adults w/o Children Undocumented Immigrants Medicaid and CHIP (Pennsylvania 2012 eligibility levels) Uninsured or insured via other coverage source 2 2
Linking Americans to Coverage (2014) FPL Unsubsidiz ed 400% Exchange 300% Subsidize d 185% 200% 133% 133% 133% Medicaid Expansion 100% 2014 100% 46% 0% 0% Children Pregnant Women Parents People with Disabilities Adults w/o Children Undocumented Immigrants Medicaid and CHIP (Pennsylvania 2012 eligibility levels) Uninsured or insured via other coverage source 2 2
Linking Americans to Coverage (2014) FPL Unsubsidiz ed 400% Exchange 300% Subsidize d 200% 133% 133% 185% 133% Medicaid Expansion 100% Basic Health 2014 100% 46% 0% 0% Children Pregnant Women Parents People with Disabilities Adults w/o Children Undocumented Immigrants Medicaid and CHIP (Pennsylvania 2012 eligibility levels) Uninsured or insured via other coverage source 2 2
What is a Health Insurance Exchange? 3
What is a Health Insurance Exchange? Massachusetts Heath Connector 3
What is a Health Insurance Exchange? Massachusetts Heath Connector 3
What is a Health Insurance Exchange? Massachusetts Heath Connector 3
Seamless Eligibility & Enrollment Individuals Small Businesses 4
Seamless Eligibility & Enrollment Individuals State Health Insurance Exchange Small Businesses 4
Seamless Eligibility & Enrollment Individuals State Health Insurance Exchange Small Businesses IRS SSA 4
Seamless Eligibility & Enrollment Individuals State Health Insurance Exchange Small Businesses IRS SSA 4
Seamless Eligibility & Enrollment Individuals State Health Insurance Exchange Basic Health Small Businesses IRS SSA 4
Seamless Eligibility & Enrollment Individuals State Health Insurance Exchange Basic Health Small Businesses IRS SSA Qualified Health Plans 4
Seamless Eligibility & Enrollment Individuals State Health Insurance Exchange Basic Health Small Businesses SHOP Exchang e IRS SSA Qualified Health Plans 4
Seamless Eligibility & Enrollment Individuals State Health Insurance Exchange Basic Health Small Businesses SHOP Exchang e IRS SSA Qualified Health Plans SHOP Qualified Health Plan 4
Setting up an Exchange: ACA Options for States 5 5
Setting up an Exchange: ACA Options for States State-administered Exchange 5 5
Setting up an Exchange: ACA Options for States State-administered Exchange Regional (Multi-state) Exchange 5 5
Setting up an Exchange: ACA Options for States State-administered Exchange Regional (Multi-state) Exchange Federally facilitated Exchange 5 5
Setting up an Exchange: ACA Options for States State-administered Exchange Regional (Multi-state) Exchange Federally facilitated Exchange Partnership Exchange 5 5
Exchange Implementation Deadlines Jan Jan Jan 2012 2013 2014 6 6
Exchange Implementation Deadlines Launch of Exchange Jan Jan Jan 2012 2013 2014 6 6
Exchange Implementation Deadlines Open Enrollment begins Launch of Exchange Jan Jan Oct Jan 2012 2013 2014 6 6
Exchange Implementation Deadlines Testing Exchange operations Open Enrollment begins Launch of Exchange Jan Jan Oct Jan 2012 2013 2014 6 6
Exchange Implementation Deadlines HHS certification and readiness review Testing Exchange operations Open Enrollment begins Launch of Exchange Jan Jan Oct Jan 2012 2013 2014 6 6
Exchange Implementation Deadlines Supreme Court ruling on ACA HHS certification and readiness review Testing Exchange operations Open Enrollment begins Launch of Exchange Jan June Jan Oct Jan 2012 2013 2014 6 6
Exchange Implementation Deadlines Supreme Court ruling on ACA HHS certification and readiness review Testing Exchange operations Open Enrollment begins Launch of Exchange Jan June Jan Oct Jan 2012 2013 2014 WE ARE HERE 6 6
State Exchange Implementation 7
State Exchange Implementation Legislation Introduced (42) 8
State Exchange Implementation Authority Established (14) 9 9
State Exchange Implementation Legislation Pending (23) 10 10
State Exchange Implementation Awaiting Court Decision (17) 11 11
State Exchange Implementation Declining State Exchange (2) 12 12
State Exchange Implementation Obtained Establishment Grants (34) 13
Key Policy Issues for Exchange Legislation 14
Key Policy Issues for Exchange Legislation State or Federal/Partnership Exchange? 14
Key Policy Issues for Exchange Legislation State or Federal/Partnership Exchange? Where should Exchange be housed? 14
Key Policy Issues for Exchange Legislation State or Federal/Partnership Exchange? Where should Exchange be housed? Who should be on any governing board? 14
Key Policy Issues for Exchange Legislation State or Federal/Partnership Exchange? Where should Exchange be housed? Who should be on any governing board? How should Exchange be financed? 14
Key Policy Issues for Exchange Legislation State or Federal/Partnership Exchange? Where should Exchange be housed? Who should be on any governing board? How should Exchange be financed? How will plans be certified? 14
Key Policy Issues for Exchange Legislation State or Federal/Partnership Exchange? Where should Exchange be housed? Who should be on any governing board? How should Exchange be financed? How will plans be certified? How to structure consumer assistance? 14
Key Policy Issues for Exchange Legislation State or Federal/Partnership Exchange? Where should Exchange be housed? Who should be on any governing board? How should Exchange be financed? How will plans be certified? How to structure consumer assistance? Hot to structure Eligibility and enrollment 14
Federal-State Partnership Options Federal Exchange Consumer Assistance Plan Management QHP 1 QHP 2 QHP 3 QHP 4 15
Questions? Contact Information Dave Chandra Center on Budget and Policy Priorities 820 First St. NE Suite 510 Washington, DC 20002 202-408-1080 chandra@ www. 16