Illinois Maternal & Child Health Coalition Starting Strong for Community Health! The Affordable Care Act and Medicaid Expansion Kathy Chan, Illinois Maternal.

Illinois Maternal & Child Health Coalition

Starting Strong for Community Health!

The Affordable Care Act and Medicaid Expansion

Kathy Chan, Illinois Maternal and Child Health CoalitionStephanie Altman, Health & Disability Advocates

Jason Montrie, Land on Lincoln Health, Inc

Tuesday, April 23, 2013

For webinar technical support, please call 800-263-6317 and press options 2, 1, 1or visit http://support.gotomeeting.com

Starting Strong for Community Health!Land of Lincoln Health:

Illinois’ Consumer Operated and Oriented Plan

About IMCHCOur Projects and Initiatives:• Campaign to Save Our

Mothers and Babies• Chicago Area Immunization

Campaign• Cooking Matters, a program

of Share Our Strength’s No Kid Hungry Campaign

• Illinois Coalition for School Health Centers

• Illinois Premature Infant Health Network

• text4baby

www.ilmaternal.org/

Healthcarereform

Become a fan on Facebook!

Follow us on Twitter at ILMaternal!



http://www.ilmaternal.org/healthcarereform

http://www.ilmaternal.org/healthcarereform

Webinar Overview



• New Non-Citizen uninsured data

• Learn more about Consumer Operated and Oriented Plans (CO-OPs) and how they differ from traditional private insurance plans;

• Hear from staff from Land of Lincoln Health, Inc. about coverage areas, benefits, and other plan details;

• Receive updates on ACA implementation efforts.

Non-Citizen Medicaid Eligibility



Current Medicaid non-citizen eligibility restrictions are maintained in 2014 including the five year waiting period (the “five year bar”) for most lawfully residing low-income immigrant adults.

The Children’s Health Insurance Program allows lawfully residing children and pregnant women regardless of their date of entry (no five year bar) by state option. Illinois’ All Kids program currently covers children with family

income under 300% FPL, regardless of immigration status Illinois’ Moms and Babies program covers pregnant women with

family income below 200% FPL, regardless of immigration status

Non-Citizen Marketplace Eligibility



Naturalized Citizens: Same access and requirements as U.S. born

citizens.

Lawfully Present: IS Eligible to Purchase Insurance from the State

Health Insurance Marketplace IS eligible for premium tax credits IS (or is reasonably expected) to be lawfully

present during entire period of enrollment IS subject to individual mandate.

2010-11 Non-Citizen Data



823,750 Non Citizens in Illinois. 430,141 (52%) are Uninsured

Total Non-Citizen Number includes: Legal Permanent Residents (LPRs) (eligible and ineligible

for Medicaid) Lawfully Present Undocumented

New version of Visualizing Health Reform (www.illinoishealthmatters.org) will have some citizenship data

http://www.illinoishealthmatters.org/

Paths to Coverage for Non-Citizens in 2014



149,283 uninsured Legal Permanent Residents in Illinois Those who have been in the US less than 5 years may

not be eligible for Medicaid but could be eligible for premium tax credits in the marketplace in 2014.

280,858 uninsured undocumented persons in Illinois No new path to coverage in 2014.

Outreach and Enrollment Issues



Reaching non-citizens will be difficult for several reasons including limited English speakers; confusion on eligibility; mixed status families; fear of immigration issues.

Undocumented non-citizens will continue to need access through county hospitals; public health departments; free and charitable clinics; federally qualified health centers.

LPRs may experience disruption in coverage moving from marketplace to Medicaid after 5 years.

What is a CO-OP Plan?



• Consumer Operated and Oriented Plan (CO-OP)– Increase competition among individual and small

group plans– Improve consumer choice in this smaller market

• Key Characteristic: consumer run governance– Policy and direction of CO-Ops are set by a board

of directors elected by a majority of membership (plan holders)

CO-OPs in ACA



• CO-Ops will offer health coverage—and possibly care networks—through the Marketplaces under the same regulatory requirements imposed on private insurance companies at the state and federal level.• CO-Ops will offer small group/individual

coverage and must be ready for open enrollment beginning on October 1, 2013

CO-OPs: Key Features/Terms



• Sponsors: “persons applying to become qualified nonprofit health insurance issuers”– Include consumer groups, community organizations,

medical provider organizations, unions, business coalitions, and other stakeholder groups.

– Sponsors must provide at least 40% of CO-OP funding• Member governed and operate with strong consumer focus• Must be a nonprofit corporation• Must offer at least 2/3 of policies on Marketplace• Must comply with state insurance laws and regulation

CO-Ops vs Private Insurance



• CO-OPs are nonprofit corporations– All surplus revenue must be used to reduce premiums,

improve benefits, or improve quality of care for its members• Consumer run governance

– The policy and direction of CO-Ops are set by a board of directors elected by a majority of the membership.

– Allow consumers to have strong voice in their health insurance options

• Included in ACA to bring competition and choice to health insurance marketplaces

Land of Lincoln Health, Inc



Jason MontrieVice President of Network and Channel

Development

Land of Lincoln Health, Incwww.landoflincolnhealth.org

http://www.landoflincolnhealth.org/

Medicaid Expansionin Illinois

• In 98th GA, SB26 (Sen. Steans) and HB106 (Rep. Feigenholtz)• SB26 passed the full Senate in February; now awaits House

action • Download a fact sheet with the list of supporters at:

http://www.ilmaternal.org/docs/factsheets/MedicaidExpansionfactsheetwithsupporters1-15-13.pdf – Contact Kathy Chan at [email protected] to add your

organization’s name• Make phone calls and send emails to your Representative!• See how SB26 affects YOUR district: # of new eligibles per

district available on www.illinoishealthmatters.org

Illinois Maternal & Child Health CoalitionFor webinar technical support, please call

800-263-6317 and press options 2, 1, 1or visit http://support.gotomeeting.com

http://ilga.gov/legislation/billstatus.asp?DocNum=26&GAID=12&GA=98&DocTypeID=SB&LegID=68456&SessionID=85

http://ilga.gov/legislation/BillStatus.asp?DocTypeID=HB&DocNum=106&GAID=12&SessionID=85&LegID=68491

http://www.ilmaternal.org/docs/factsheets/MedicaidExpansionfactsheetwithsupporters1-15-13.pdf

http://www.ilmaternal.org/docs/factsheets/MedicaidExpansionfactsheetwithsupporters1-15-13.pdf

mailto:[email protected]

http://www.illinoishealthmatters.org/

Additional Pending Policy Decisions

• Establishment of a state-based competitive health insurance marketplace

• SB1194/HB2608 – “Bad” Navigator Bill – Fact sheet posted at

http://ilmaternal.org/docs/factsheets/OPPOSE_SB1194-HB2608Factsheet_03-13-2013.pdf

– Contact Kathy Chan at [email protected] to add your organization’s name

• Implementation of Medicaid reform legislation• State budget challenges - ongoing need to preserve Medicaid and

related programs Illinois Maternal & Child Health CoalitionFor webinar technical support, please call




mailto:[email protected]

Advocacy Opportunities



• Governor’s Health Reform Implementation Council Meetings: www.healthcarereform.illinois.gov

• Medicaid Advisory Council and subcommittees: http://www2.illinois.gov/hfs/PublicInvolvement/BoardsandCommisions/MAC/Pages/default.aspx

http://www.healthcarereform.illinois.gov/

What You Can Do! • Spread the word!• Subscribe to IMCHC’s newsletter and action

alert, Facebook, Twitter (@ILMaternal)• Download and share our factsheets and

toolkit• Subscribe to our podcast• Invite us to present and suggest future topics• Bookmark www.illinoishealthmatters.org



IMCHC’sACA Ambassadors

• Get paid to learn about health reform!• Affordable Care Act (ACA) Ambassadors. ACA Ambassadors will serve

as an extension of IMCHC as we work to help communities understand health reform and the impact on families, individuals, and businesses. – ACA Ambassadors should live in the Chicagoland area, including

suburbs and collar counties • ACA Ambassadors will receive a stipend of $600 if they successfully

meet the established goals. • Learn more and submit application online. Application deadline is May

10. http://www.ilmaternal.org/acaambassadors.html



Next Webinar: May 21

Register now for the next Starting Strong Webinar on May 21 from 2-3pm

Connecting Consumers to Coverage: Navigators, In Person Assistors, and Certified Application

Counselorshttps://www3.gotomeeting.com/register/576702254

Illinois Maternal & Child Health CoalitionFor webinar technical support, please call


Questions?

Stephanie [email protected]

www.hdadvocates.org

www.illinoshealthmatters.org


Kathy [email protected]

312-491-8161x24www.ilmaternal.org


Resources


Illinois Maternal & Child Health Coalition Starting Strong for Community Health! The Affordable Care Act and Medicaid Expansion Kathy Chan, Illinois Maternal.

Documents