Health Reform and Older Adults: Opportunities for Funders

1. Health Reform and Older Adults: Opportunities for Funders Kim VanPelt St. Luke’s Health Initiatives October 18, 2013

2. Coverage Expansion Employer-based coverage Medicaid The “Exchange”

3. Insurance Coverage and the Pre-Medicare Population • More likely to be covered than other demographic groups • 12 percent uninsured among 50-59 year olds versus 28 percent uninsured among 18–28 year olds • However, more likely to uninsured due to cost, more likely to be delaying care

4. Uninsured, Pre-Medicare Population

5. Medicaid Expansion • Increases eligibility up to 138 percent of the federal poverty level • Over 300,000 Arizonans will benefit • Allows for coverage to childless adults, many of whom are older adults without children living at home • SLHI supported polling, messaging and advocacy • Approximately 60 percent of voters support expansion • Eligibility screening began October 1, coverage begins on January 1, 2014

6. The Marketplace • Online site for individuals and small businesses to compare and purchase health coverage • Intended to simplify and structure health insurance choices for individuals, families and small businesses • Exclusive mechanism for receiving federal subsidies and plans with cost-sharing limits • Open enrollment began October 1 • Open enrollment will occur through the end of March • 1.3 million Arizonans predicted to eventually receive coverage through the marketplace

7. Premium Subsidies • Tax credit is advanceable or refundable • Eligibility is based on • Projected household income and family size • 100 – 400% FPL ($23,550 -$94,200 for a family of four in 2013) • Obtaining qualified coverage through the marketplace • Ineligible for government-sponsored coverage, affordable-sponsored insurance, or certain other minimum essential coverage • Tax credits available to immigrants who are lawfully present

8. Cost Sharing Reduction • Eligibility for reduced cost sharing is based on • Incomes at or below 250% of FPL ($58,875 annually for a family of four in 2013) • Receiving the new premium tax credit • Enrolling in a marketplace silver-level plan

9. Cover Arizona • More than 600 organizational members • Focusing on awareness, outreach, enrollment assistance • Varied strategies based on demographics, geography, special populations

10. Strategies for Older Adults • Partnering with AARP, Area Agency on Aging on outreach activities • Working with Area Agency on Aging, Corporation for National and Community Service and Retired and Senior Volunteer Program (RSVP) volunteers to develop an infrastructure for enrollment assistance

11. Need more information www.healthcare.gov www.marketplace.cms.gov www.coveraz.org

12. www.slhi.org