AFFORDABLE CARE ACT: VA COMMUNICATION FRAMEWORK

1. AFFORDABLE CARE ACT: VA COMMUNICATION FRAMEWORK July 24, 2013 DEPARTMENT OF VETERANS AFFAIRS

2. Affordable Care Act (ACA) Overview • ACA represents comprehensive reform of the health care delivery system and is intended to expand access to coverage, control health care costs and improve health care delivery system. • ACA requires most individuals to have minimum essential health care coverage for themselves and their dependents or make a payment when filing taxes for each month lacking coverage. • Enrollment in VA health care, CHAMPVA and Spina Bifida programs meet the minimum essential coverage standard. • Certain individuals, based on their income, may be eligible for assistance to lower the cost of health care coverage premiums. • States have the option to expand Medicaid eligibility to up to 138% of the Federal Poverty Level • Establishment of Health Insurance Marketplaces where individuals and small businesses can compare policies and premiums, and buy insurance coverage.

3. ACA and VA – Enrollment Changes • Enrollment changes may occur as Veterans respond to the new choices that are available to them • States’ decision on Medicaid expansion may impact health care choices for Veterans who may become newly eligible for Medicaid • ACA expands Medicaid eligibility up to 138% of the Federal Poverty Level • According to the 2010 VHA Survey of Veteran Enrollees’ Health and Reliance upon VA, 584,000 enrolled Veterans are also enrolled with Medicaid • Those most likely to change their enrollment status are non-users or have low reliance on VA

4. ACA and Veterans • Enrolled Veterans can continue to use VA and other federal health care coverage including Medicare, Medicaid, TRICARE or private insurance. • Since enrollment meets the requirement for coverage under the law, they are not eligible for assistance in purchasing insurance. • ACA will give some Veterans the choice to decide whether to use VA for health care, or choose non-VA options. • Increased choices have implications for VA in the areas of outreach and communications. • Veterans will expect VA to be able to assist them in understanding their options and deciding what’s best for them and their families.

5. VA’s Overarching Communication Strategy • VA’s focus is two fold: • Educate Veterans that VA health care meets ACA health insurance standards and (for those not currently enrolled), promote VA health care as an option; and • Communicate to Veterans and their families the value of health insurance and provide information about the Marketplace to those not eligible for care through VA, including Veterans’ families. • To execute a multi-faceted strategy to engage with Veterans, staff and other stakeholders about VA and ACA. • There are approximately 22M Veterans, 8.2M are enrolled in VA health care programs. • There are an estimated 1.3M uninsured Veterans, most are eligible for VA health care. • To ensure consistent communications with these audiences, VA has developed key messages to share with Veterans and other VA beneficiaries. • VA will communicate information on ACA, using various modalities starting in July 2013.

6. VA Overarching Communication Strategy (cont.)

7. Key Messages • VA wants all Veterans to receive health care that improves their health and well-being. • VA will assist Veteran and other beneficiaries to determine their eligibility for VA health care and other health coverage options. • If enrolled in VA health care, a Veteran does not need to take additional steps to meet the health care law coverage standards. • The health care law does not change VA health benefits or Veterans’ out-of-pocket costs. • Veterans and other beneficiaries not currently enrolled in VA health care can apply for enrollment at any time. • Our doors are open – applications are accepted online at www.va.gov/healthbenefits/enroll, by phone at 1-877-222-VETS (8387), by mail, or in person at a VA medical facility. • VA will continue to provide Veterans with high quality, comprehensive health care and benefits they earned through their service. • Veterans’ family members and Veterans not eligible for VA care may secure coverage through the Marketplace. 

8. Planned VA Outreach Efforts • Landing Site (interactive website with ACA information, comparison tool, etc.) • Veterans’ family members webpage with link to healthcare.gov • Direct Mail • Print/Online/Media Communications • Social Media (Facebook, Twitter, Blogs) • In-Person Communication Tools • Collaboration with other Federal agencies and partners • HHS, DoD, DOL, SBA • State Governors and State Veterans Agencies • Leverage partnership opportunities • VSOs , NGOs, MSOs • Veteran small business owners • Grantees

9. Communication Timeline • September / October 2013 • Continue mailout of ACA letter to enrollees • Continue outreach campaigns • August 2013 • Publish Vanguard article • Continue ACA letter/packages to enrollees • Begin outreach to not enrolled Veterans • Continue enhancing content and capabilities on www.va.gov/aca • Release content for VSO, SDVA websites and print communications • Present at VSO National Conferences • Release PSAs and YouTube video • Initiate outreach to States • May 2013 • Release interim www.va.gov content changes • Enhance call Center scripts • Introduce approved communications materials e.g. FAQ, Fact Sheet at NLC summit • Conduct www.va.gov/aca focus group review • Maintain intranet site for staff to access information / tools • June 2013 • Develop ACA website • Release Health Benefit Explorer on va.gov/healthbenefits • Release VHA staff training on ACA • Finalize direct communications materials • July 2013 • Focus group ACA website and Explorer • Launch www.va.gov/acafeaturing content & Health Benefits Explorer • Release VAMC ACA communications toolkit • Begin mailing ACA letters/ information package to enrollees • Add ACA to Enrollment materials • Release new streamlined 10-10EZ • Expand call center staffing/hours; web-chat • Release social media messages • Identify facility ACA Advisors ACA Open Season begins 5/2013 6/2013 7/2013 8/2013 9/2013 10/2013

10. VA ACA Landing Page www.va.gov/aca

11. VA Health Benefits Explorer

13. Outreach Campaigns • CBO plans to initiate outreach to 166,000 not Enrolled VA Education beneficiaries beginning in August • CBO seeks opportunities to partner with VISNs to outreach to other not enrolled Veteran groups • High Potential Targets: • Under Age 65, particularly Young Adults • Low and Moderate Income • Enrollment Eligibility, e.g., Service-Connected, Vietnam Vets • Declining or Stable Markets • Encourage facility leadership to form local alliances to indentify uninsured Veterans, and help them make informed choices about their health

14. HHS ACA Outreach Efforts • Educate the American public about the value of health insurance and to encourage purchasing insurance through the Health Insurance Marketplace for those who need it • HHS launched a redesigned website www.healthcare.gov • HHS outreach and communications efforts include: • Create call centers in 6 states to support the 34 states where the Federal Marketplace will be implemented (call centers are using VA-supplied scripts) • Assistance to community health centers to help enroll people in health insurance

15. VA Visibility on healthcare.gov

16. Next Steps • Release additional communication materials • Creditable Coverage letter • Add ACA to TAP and Demo (transition) presentations • Guides for Enrolled and Not Enrolled Veterans • Enhance VA Health Benefits Explorer to identify other health care coverage options for Veterans • Develop external Navigator (HHS) training materials • Develop not enrolled and uninsured Veterans outreach campaigns

17. Questions