National Landscape: Where Have We Been, and Where Are We Headed? Jessica Kendall, MPH Director of the Enrollment Assister Network Kara Nester, MPH Field.

National Landscape: Where Have We Been, and Where Are We Headed?

Jessica Kendall, MPHDirector of the Enrollment Assister Network

Kara Nester, MPHField Associate

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Federal Landscape

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Medicaid Expansion

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AlaskaHawaii

As of March 23, 2015

Federally-facilitated

marketplace

Federally-supported state-

based marketplace

State partnership marketplace

State-based marketplace

M Medicaid Expansion

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

MM

M

M

M

M

DC:M

State Health Insurance Marketplaces & Medicaid Expansion

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King vs Burwell – How Does It Impact You?

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There is no immediate threat to consumer tax

credits until a Court ruling in June. They should proceed as

normal.

Even if the Court rules against the ACA,

consumers will not have to pay back any

previous tax credits.

An Urban Institute Study showed 8.2

million people would be uninsured and

premiums would increase by 35%.

The ACA was intended to provide affordable health coverage for consumers is every state, not just a few.

King vs Burwell – How Does It Impact You?

If you want to protect the law, share stories!

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YAY, Bipartisanship!!

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Extension of CHIP funding for 2 years under current law

• Authorization of express lane eligibility (ELE) through FFY 2017• 23 percentage-point increase to the federal CHIP match, which begins October 1, 2015 (FFY 2016)

Funding for community health centers

• 2 year extension

Permanently authorize Transitional Medical Assistance

President Obama signs HR 2 into law

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Enrollment Overview

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LATEST ENROLLMENT: Almost 23 Million!

Families 10.USA

2013

11.7 Million11.2 Million

Total Enrollment

QHP

Medicaid

QHP Enrollment numbers as of February 22, 2015  (http://aspe.hhs.gov/health/reports/2015/MarketPlaceEnrollment/Mar2015/ib_2015mar_enrollment.pdf)Medicaid Enrollment numbers as of January, 2015 (http://medicaid.gov/medicaid-chip-program-information/program-information/downloads/medicaid-and-chip-january-2015-application-eligibility-and-enrollment-data.pdf)

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A Closer Look at Indiana

Medicaid Enrollment numbers, including renewals, as of January 2015, since October 2013, (http://www.medicaid.gov/medicaid-chip-program-information/program-information/downloads/medicaid-and-chip-january-2015-application-eligibility-and-enrollment-data.pdf).QHP enrollment data as of February 22, 2015 (http://aspe.hhs.gov/health/reports/2015/MarketPlaceEnrollment/Mar2015/ib_2015mar_enrollment.pdf).

277,329 Hoosiers enrolled in Medicaid

and CHIP

219,185 Hoosiers enrolled in plans

through the Marketplace

87% of enrollees received financial

help

Average reduction in premiums = 73%

60% of total enrollment is

children

7% increase in enrollment

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Success in Indiana

11%

Source: Gallup’s uninsured estimates from February 25, 2015 (http://www.gallup.com/poll/181664/arkansas-kentucky-improvement-uninsured-rates.aspx)

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Enrollment

Indiana Wisconsin Missouri Maryland Tennessee0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000Enrolled

Uninsured*

Combined QHP enrollment as of February 22 (http://aspe.hhs.gov/health/reports/2015/MarketPlaceEnrollment/Mar2015/ib_2015mar_enrollment.pdf) and Medicaid enrollment as of January 2014 (http://medicaid.gov/medicaid-chip-program-information/program-information/downloads/medicaid-and-chip-january-2015-application-eligibility-and-enrollment-data.pdf) *Estimates before OE1 from the Centers for Medicare and Medicaid Services Analysis of 2011 American Community Survey (https://data.cms.gov/dataset/The-Number-of-Estimated-Eligible-Uninsured-People-/pc88-ec56)

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Enrollment Timeline

Families USA2013

February 15th 2015 OPEN ENROLLMENT CLOSED

• Medicaid and CHIP enrollment OPEN ALL YEAR

Special enrollment periods for people with certain life changes

• February 15th -November 1st

November 1st 2015- January 31st 2016

• Next open enrollment period

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Reaching the SEP Population

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Debrief

Medicaid and CHIP enrollment

Special Enrollment periods

Outreach and education

Appeals

Help consumers navigate system

Continuing building relationships

Post-Open Enrollment: Now What?

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Special Enrollment Periods (SEPs)

• Tax season• Lose minimum essential

coverage• In non-expansion states:

becoming newly eligible for marketplace coverage

• Marriage• Birth, adoption, placement

for adoption, or gaining a dependent due to child support or court order

• Move to a new QHP service area (including leaving incarceration)

• Losing a hardship exemption

• For those already enrolled: change in eligibility for cost sharing reductions or premium tax credits

• Gain lawful immigration status or citizenship

• Enrollment error or misconduct by the marketplace

• QHP violated its contract• Plan no longer offered• Other “exceptional

circumstances” as determined by the Marketplace

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State Example: Florida

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State Example: Utah

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Where and how do you find people who…?

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• Where do you find people who are getting, or just got married?

• Faith organizations, county offices, wedding venues, bridal shops

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• How do you find people who lost their job or changed jobs?

• Employment offices, seasonal workers, job training programs

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• Where or how do you find people who had a baby or adopted a child?

• Baby stores, mom blogs, hospitals, adoption agencies

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• Where or how do you find people who’s immigration status just changed?

• Immigrant related groups, immigration lawyers

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• Where or how do you find people just lost their health insurance? Turned 26?

• Social service agencies, community colleges, providers

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• Where or how do you find people who are going back and forth between Medicaid and the Marketplace?

• Your clients?! WIC offices, social service agencies, businesses

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SEP

Lost coverage

Lost job

Birth, adoption, placement for adoption

Marriage

Taxes

Citizenship

Move

Turn 26

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Reaching the Medicaid population

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State Example: Michigan

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Connecting Community Resources

Where are your touch points?

What are your clients needs?

How can you tap into your existing network?

How can you target people who will also use your services?

1201 New York Avenue, NW, Suite 1100Washington, DC 20005

main 202-628-3030 / fax 202-347-2417

Questions?

Jessica Kendall Kara [email protected] [email protected]

http://familiesusa.org/initiatives/enrollment-assister-resource-centerhttp://familiesusa.org/health-action-network