Asheville, North Carolina May 2013 United Way and the Affordable Care Act: What You Need to Know as Consumers, Advocates, and Social Entrepreneurs United.

The Bottom Line: What you need to know…

• Connecting children and families to coverage is completely aligned with our mission

• There’s a good chance you could raise money to do it

April 19, 20232

The Bottom Line: What you need to know…

• ObamaCare is the law of the land and it’s not going anywhere

• Connecting Americans to coverage is completely aligned with our mission

• Insurance companies understand that the better the law works, the more money they will make

• United Ways and 211s have incredible reach to the uninsured, reach that no other organizations have

• United Ways and 211s should monetize our outreach and education efforts AND GET PAID TO DO THIS WORK!

• Figure out how broad your reach is, and shop it around – insurance companies and foundations will be very interested to know how you reach people and how many you can reach, and help us give them new customers

April 19, 20233

If you’re to remember anything from this preso…

Agenda

• Brief Overview of the Affordable Care Act

• Outreach and Enrollment for the new Health Benefits Marketplaces – Consumer Assistance

• Marketing – the Messaging that Resonates with Consumers

• Advocacy for the Full Funding of Medicaid

April 19, 20235

The Patient Protection and Affordable Care Act of 2010

• Passed by Congress and signed by President Obama in March 2010

• 32 million Americans could gain coverage through an expansion of Medicaid to cover families earning 133% of the Federal Poverty Line (FPL)

• Graduated scale of premium subsidies for those between 134 and 400% of FPL

• Health Benefit Exchanges at the state level or by the federal government expected to cover roughly 16 million more Americans

• Private health insurance reforms, such as:

• No pre-existing conditions or lifetime caps

• Free prevention screenings

• Coverage for children on parents’ plans up until the age of 26

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Who Can Be Navigators?

Navigators assist with five things…

1. Public education campaigns

2. Medicaid and CHIP eligibility and Advanced Premium Tax Credits

3. Enrollment process

4. Referrals

5. Language and culture

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SHOP Marketplace for Employers

• Purchasing pool to increase buying power and reduce administrative costs

• Small businesses with fewer than 100 workers eligible

• Those businesses with fewer than 50 are not required to provide health insurance

April 19, 20239

The 2014 Enrollment Opportunity

Source: July 2012 CBO estimates

Enroll more than 16 million people in new coverage options

}9 million in Exchange coverage

7 million in Medicaid or CHIP}11

Enrollment isn’t a snap…

ProgramPercent of Eligible

People Enrolled

Children’s Medicaid/CHIP, national average, 2009

84.8%

Medicare low-income subsidy, 2009* 40%

Unemployment benefits 72-83%

Earned income tax credit 80-86%

SNAP (food stamps) 54-71%

* Does not include populations automatically enrolled in the low-income subsidy.

Take-up in optional public benefit programs

Where are the

Uninsured?

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Two-thirds of the uninsured live in twelve states

• Arizona• California• Florida• Georgia• Illinois• Michigan• New Jersey• New York• North Carolina• Ohio• Pennsylvania• Texas

Demographic Profile of the Uninsured(Nonelderly Adults, Ages 18-64)

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53%

47%

Race/EthnicityPercent of Uninsured

Uninsured Rate

White (non-Hispanic) 45% 13%

Black (non-Hispanic) 15% 21%

Hispanic 32% 32%

Asian/Pacific Islander 5% 18%

American Indian/Alaska Native

1% 27%

Two or More Races 2% 15%

62%Live in Families

with at least One Full Time

Worker

Source: Kaiser Commission on Medicaid and the Uninsured, October 2012

Limited Public Awareness

The majority of uninsured Americans who may be Medicaid eligible don’t know the health reform law will help them.

75%

Three out of four of the newly eligible want in-person assistance to learn about and enroll in coverage.

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Enroll America Research, November 2012

83%

Help, I Need Somebody!

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Building an Effective Campaign

Grassroots field effortsGrassroots field efforts

Creative use of social media

Creative use of social media

National and local

surrogates

National and local

surrogates

Education & engagement through partner entities

with direct reach to target populations

Education & engagement through partner entities

with direct reach to target populations

Earned media events and Activities in communities to

magnify messaging

Earned media events and Activities in communities to

magnify messaging

Enrollment assistance by

trusted community

sources

Enrollment assistance by

trusted community

sources

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Paid advertising on TV, radio online, and in print media

Paid advertising on TV, radio online, and in print media

Paid advertising on TV, radio, online, and in print media

Paid advertising on TV, radio, online, and in print media

Data, Analytics,

Micro-targeting

Data, Analytics,

Micro-targeting

Constituency engagementConstituency engagement

Strategic Partner-

ships

Strategic Partner-

ships

Research Design

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Segmentation

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For many, looking for health coverage is a negative experience.

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How they want to feel is confident, informed, secure, satisfied, and in control.

If you had to look for health insurance now, what feelings do you think you

would have?

Key Findings

Four Key Facts to Reach Most Uninsured

Targeting Messages

An Action Plan for Organizations

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1. Identify the leading partners in your state or area (you don’t have to be the expert!)

2. Recognize everyone’s role in outreach

3. Create an outreach and public education plan

4. Disseminate information

5. Follow up, follow up, follow up!

Collaboration is the name of the game!

1. How are you currently partnering with organizations to discuss enrollment?

2. What are you currently doing in regards to current program outreach activities and planning for future health coverage outreach efforts?

3. What tools / resources have you used in the past and what are you currently using?

4. Have you leveraged your workplace giving campaigns to inform contributors of opportunities in the community?

5. Describe coalitions that you currently participate in that have a health as a focus. Successes? Unlikely partners?

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What are the three things I can do?

1. Talk to your friends and family about Open Enrollment 2013/2014 and the new options that will be available to them

2. Get informed and prepared to handle the call volume and health insurance questions that are coming

3. Stay tuned to www.enrollamerica.org and www.healthcare.gov for more information

April 19, 202327

April 19, 202329

State and/or Local United Ways Advocating for Medicaid Maximization

1: Yes, we are absolutely advocating for Medicaid Maximization in our state!

Alaska Nevada

California South Carolina

Colorado Tennessee

Illinois

Iowa

Florida

Michigan

April 19, 202330

State and/or Local United Ways Advocating for Medicaid Maximization

2: Yes, but we are working behind the scenes.

Arizona

Georgia

Indiana

Louisiana

Maine

Montana

Ohio

Washington

April 19, 202331

3: We are not quite sure – we’re still feeling it out.

Alabama Rhode Island

Arkansas Texas

Maryland Utah

New Jersey Wisconsin

North Carolina

Pennsylvania

April 19, 202332

State and/or Local United Ways Advocating for Medicaid Maximization

United Way Advocacy on Medicaid

4: No, we do not plan to advocate on this issue at this time.

District of Columbia

Minnesota

New York

NB: The political leadership of these jurisdictions are fully supportive of accepting Medicaid money. Advocacy on this front is not necessary.

April 19, 202333

Key Medicaid Messaging

• DON’T CALL IT MEDICAID EXPANSION!

• Accepting Medicaid money

• Strengthening Medicaid

• Serving everyone eligible for Medicaid

• Maximizing Medicaid

• Families care about their health and financial security. Medicaid is a pocket-book issue

• A close look at the calculus shows that Medicaid is good for state budgets and economies

• Kids can’t learn if they’re not healthy. Education outcomes are dependent upon Health Access

April 19, 202334

Key Medicaid Messaging

Expanding Medicaid is a good deal for our state. It’s a smart/small investment that saves dollars and is good for our bottom line.

•Use state-level data/research when possible that shows potential savings outweigh the costs

•It will ensure health dollars are spent more effectively by reducing uncompensated-care costs for hospitals and clinics that currently serve people without insurance

•It will bring millions in federal funding into the state. Let’s bring back our tax dollars to pay for our state’s priorities

•Republican Governors on Medicaid Maximization: http://www.youtube.com/watch?v=4WOqxDOjCOs

April 19, 202335

Key Medicaid Messaging

Failure to maximize Medicaid will have negative consequences for local hospitals:

•Many of our state’s hospitals rely on Medicaid dollars to provide essential services and equipment, such as state-of-the-art NICUs and professional development training to doctors and nurses

•Without Medicaid, hospitals will be forced to absorb all the costs for treating the uninsured – causing some hospitals, especially those in rural areas, to close

•Hospitals are essential to keeping our communities healthy and they are also economic engines. Accepting Medicaid money helps keep them strong.

April 19, 202336

If you’re to remember anything from this preso…