Transcript THE UNITED CHURCH OF CHRIST Presents “Helping Those You Serve – Connect to Health Care Coverage” Designed for Pastors, Health and Outreach Ministries, Church Members.

THE UNITED CHURCH OF CHRIST
Presents
“Helping Those You Serve –
Connect to Health Care
Coverage”
Designed for Pastors, Health and Outreach Ministries, Church Members
WHAT YOU NEED TO KNOW ABOUT THE
AFFORDABLE CARE ACT
SUNDAY, OCTOBER 13, 2013
PRESENTER
Yvonne Oliver, M.A.
Program Associate, Health Care Justice
Justice and Witness Ministries
United Church of Christ
WHY WE ARE HERE TODAY
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Educate
Provide facts
Dispel myths
Inform the congregation of healthcare
decisions they may need to make
Provide a forum for discussion
CHURCH’S ROLE IN HEALTH CARE
The most important dimension to health is spiritual
Our immune system is directly related to the
community we live in and all aspects of the
environment
Harmony with the creator, neighbors and earth is
needed to survive any type of tragedy
Moral Issues
We are Called to Care for Each Other
Today’s Presentation Goals
• The benefits of Patient Protection Affordable
Care Act
• How to sign up for health insurance coverage
• Explain the Market Place
• What is a Navigator
• What are the 10 Essential Benefits
• Who can be Certified Application Counselors
• Resources to connect people
KAISER FAMILY FOUNDATION
http://www.youtube.com/watch?v=JZkk6ueZt-U
THE BUILDING BLOCKS OF THE ACA
Expands access to insurance
Increases consumer protections
Emphasizes prevention and wellness
Improves quality and
outcomes of care
Lowers health care costs
Good for the economy
EXPANDS ACCESS TO INSURANCE
 50% Drug discounts for Medicare
 Physician quality reporting
 New payment system rewards providers for quality of care rather
than volume of services
 Medicare increases payment to primary care providers 10%
 Employers required to disclose value of benefits
 Establishes choice for purchasing voluntary community living
assistance
CONSUMER PROTECTIONS
 80% of collected premiums must be spent on health
care
 Readmission Reduction Program
 No lifetime or annual dollar cap
 Insurers cannot deny care or payment
 States review large rate increases
 Women not charged higher rates
 Consumer’s right to choose their doctor
ACA GOOD FOR THE ECONOMY AND JOBS
• Training, grants, scholarships to expand physicians,
nurses, Physicians Assistants
• Grants to educational institutions to expand training
• Small business can receive tax credits
• Healthier, more productive employees
• National Health Service Corps repays loans to health
care providers working with underserved
Improves quality
and outcomes of
care
ACA BENEFITS NOW WORKING FOR YOU
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Insurance companies cannot drop you when you get sick
Mental health/substance use services
No lifetime limits
Young adults can stay on parents plan up to age 26
Children with pre-existing conditions cannot be denied
No co-pays for preventive services
Some businesses currently qualify for tax credits then
increase in 2014
ACA BENEFITS NOW WORKING FOR YOU
 50% Drug discounts for Medicare
 Physician quality reporting
 New payment system rewards providers for quality of
care rather than volume of services
 Medicare increases payment to primary care providers
10%
 Employers required to disclose value of benefits
 Establishes choice for purchasing voluntary
community living assistance
WHAT’S HAPPENING NOW?
• Six Month Open Enrollment
• October 1, 2013 thru March 31, 2014
• In the Marketplace you will be able
to apply, compare plans, and enroll.
• Coverage starts as soon as January 1, 2014.
• Check your state’s website and Hot Line
• Medicaid Expansion
WHAT’S HAPPENING NOW?
• States have created their insurance market
places; and navigator training Programs.
• Health disparity is a key issue.
• The National Partnership for Action, Office on
Minority Health and Health and Human
Services and others are releasing reports and
standards to help guide this work.
THE ACA AND HEALTH DISPARITIES
• Expands funding for community
health centers.
• Provides funding for health
prevention programs (Community
Transformation Grants, the
Innovation Grants program and
others.)
THE ACA AND HEALTH DISPARITIES SUMMARY
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Reinforces the requirement for
hospitals to do community needs
assessments and community benefits
plans.
Requires data on race and ethnicity to
be collected by all public health and
health care organizations.
THE ACA AND HEALTH DISPARITIES
• Provides funding for community
health workers.
• Provides funding to increase
workforce development activities.
• Supports the development of new
models of care.
WHO IS UNINSURED
Total Population
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82
WHO IS UNINSURED?
Healthy & Young
47.8
52.2
WHO IS UNINSURED?
Sick, Active & Worried
28.9
71.1
WHO IS UNINSURED?
Passive & Unengaged
15.3
84.7
SHOPPING FOR HEALTH INSURANCE
INSURANCE MARKETPLACE IN 2014
• Millions of people will use the Health
Insurance Market Place
• Creates one-stop shopping for easy
comparison of coverage options
INSURANCE MARKETPLACE IN 2014
• Gives you more choice and control
• Subsidies for individuals and tax credits
for small businesses are available to
make it more affordable
• Congress will get its coverage through
the same Market places
INDIVIDUAL RESPONSIBILITY REQUIREMENT
HOW CAN I OBTAIN
COVERAGE?
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Employer
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Medicaid/CHIP
WHO IS EXEMPT
M A N DAT E ?
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Medicare/TRICARE
The exchange: Financial help
through subsidies will be
available
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FROM THE
Individuals with religious
objection
Undocumented immigrants
Individuals whose income is
below the threshold
required to file a tax return
Individuals where the lowest
cost health plan available
exceeds 8% of their income
PLANS MUST MEET CERTAIN COVERAGE LEVELS
Bronze
Silver
Gold
Platinum
Navigators: Connecting People
with the Insurance Market Place
The Market Place is required to create a navigator program
to:
Inform people about their new insurance options
Help people enroll in their plan of choice
Help people keep their coverage (stay enrolled)
Navigators – Connecting People
with the Insurance Market Place
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Required by the Marketplace
Federally funded
Complete a 20 hour of training
Knowledge of state Qualified Health Plans
Conduct outreach and education
Give fair and impartial information
Provide culturally and linguistically competent information,
and in a manner that is accessible for people with
disabilities
CERTIFIED APPLICATION COUNSELORS
(CACS)
• Additional program to assist with enrollment, not
federally funded
• Allows community health centers, hospitals,
community and social service agencies to also assist
with outreach and enrollment into the marketplace.
• Training and skills required to provide reliable, secure
assistance.
• Critical to achieving a high rate of enrollment.
AGENTS AND BROKERS
• Agents and brokers can:
• Help enroll people and small employees into
the marketplace.
• Provide information on Qualified Health Plans
• Agents and Brokers must follow Federal
training and register to conduct business in
the marketplace.
• Can receive compensation for enrollment.
ENROLL AMERICA
• Working to increase the number of people
who will gain health insurance through the
Affordable Care Act.
• Get Covered America campaign is working
with groups to do grassroots education and
dialogue with communities
ACA BEST PRACTICES FOR CHURCHES
The goal of the ACA is to move away from a culture of sickness to a
culture that emphasizes prevention and wellness.
Churches are trusted sources of information and will have a key role
in helping to connect uninsured people to healthcare .
A church or groups of churches can partner with neighboring
congregations or social service agencies or health centers to
host enrollment events.
Share information with church and community members about
enrollment. The ACA requires that all materials be written in
plain language, reading levels for newspapers writing is 6th-8th
grade.
ACA BEST PRACTICES FOR CHURCHES
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www.healthcare.gov for the most accurate information. View
“Youtoons” produced by Kaiser Family Foundation www.kff.org
Go to www.EnrollAmerica.org enrollment information.
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Consumer Assistance Counselors will be available to provide
information but they do not enroll, only navigators or brokers can
enroll.
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Engage Faith Community Nurses in your conference to assist
churches.
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Encourage patients to find a doctor and build relationship so that
you can become connected with a medical home.
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Be Patient.
TAKE ACTION – GET INVOLVED
Stay involved by -
Writing letters to the editor
Speaking to others about the ACA
Calling legislators
Calling volunteers
Attending rallies and events
Hosting a house party
Share your story with us to help someone else.
HHS.GOV
RESOURCES
• www.healthcare.gov
• http://www.enrollamerica.org
• Kaiser Family Foundation – Test drive the
calculator – interactive tools, fact sheets
• www.kff.org
• Faithful Reform
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(www.faithfulreform.org )
RESOURCES
www.ConsumerReportsHealth.org
www.commonwealthfund.org
www.statehealthfacts.org
www.hhs.gov/partnerships/aca_act_and_co
mmunity/index
• www.marketplace.cms.gov/getofficialresourc
es/multimedia/multimedia.html
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ADDITIONAL INFORMATION
Yvonne Oliver, M.A.
United Church of Christ
Healthcare Justice Program Associate
Justice and Witness Ministries
700 Prospect Avenue East
Cleveland, Ohio 44115 – 1100
216-736-3710
[email protected]