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The Affordable Care Act: Implications for the Health Care Landscape. Presented by Deb Polun Director of Government Affairs/Media Relations Community Health Center Association of Connecticut. First… a bit about Federally-Qualified Health Centers (FQHCs). What is a community health center?

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the affordable care act implications for the health care landscape

The Affordable Care Act:Implications forthe Health Care Landscape

Presented by Deb Polun

Director of Government Affairs/Media Relations

Community Health Center Association of Connecticut

b ackground

What is a community health center?

Also called “federally qualified health centers,” they provide medical, dental and behavioral health services to people regardless of ability to pay.

Background
b ackground1

Community health centers also provide

“enabling services,” such as transportation,

translation and referrals to specialists.

They are recognized and partially funded by the federal government. State governments also provide additional funding.

Background
b ackground2

Community health centers are located in urban and rural areas across the country.

Nationally in 2012:

  • 1159 community health centers (8500+ sites)
  • 21 million patients
Background
b ackground3

14 separate

health centers

Over 200 sites

Over 340,000 patients

Over 1.6 million visits

Background
b ackground4

In Connecticut:

  • 58% of patients are on Medicaid
  • 23% are uninsured
  • About 6% are on Medicare
  • 29% are best served in a language other than English
Background
slide8

Why did the federal government think we needed health reform?

Patient Protection and Affordable Care Act

the aca is aimed at

Improving the health of Americans

  • Integrating health care
  • Controlling health care costs
The ACA is aimed at:
slide10

Signed into law on March 23, 2010

  • Immediately challenged by a number of states and the National Federation of Independent Business

Patient Protection and Affordable Care Act

patient protection and affordable care act

US Supreme Court consolidated cases and ruled most provisions constitutional on June 28, 2012

  • Since its enactment, the US House of Representatives has made 42 efforts to repeal its enactment
Patient Protection and Affordable Care Act
individual mandate

All individuals must have a certain level of health insurance coverage or else pay a fee

    • Effective 2014
    • Penalty in 2014 is $95/year or 1% of income, whichever is greater.
Individual Mandate
slide14

Provisions will be put into place to make the purchase of health insurance easier and more affordable:

  • Changes to commercial insurance
  • Help from employers
  • Expansion of Medicaid
slide15

Provisions will be put into place to make the purchase of health insurance easier and more affordable:

  • Help from the government
  • Establishment of insurance marketplaces (“Exchanges”)
commercial insurance provisions

Young adults up to age 26 can be carried on their parents’ insurance plans (2010).

  • Individuals with pre-existing conditions will not be denied coverage or charged extra (kids: 2010; adults: 2014).
Commercial Insurance Provisions:
commercial insurance provisions1

Insurance companies cannot cancel coverage just because the enrollee gets sick (2010).

  • Preventive care, such as vaccinations and screenings, will be covered (2010).
  • Women cannot be charged more than men (2014).
Commercial Insurance Provisions:
commercial insurance provisions2

80-85% of premium dollars have to go to health care – or they must refund the extra (2011).

  • Lifetime limits will be eliminated (started in 2010, full implementation in 2014).
Commercial Insurance Provisions:
impact on employers

Large employers will be required to either cover their workers or pay a fine (originally 2014, now delayed to 2015).

  • Small businesses will not be required to provide coverage to their employees, but if they do, they can receive a tax credit (2010).
Impact on Employers:
changes to medicaid

States can expand Medicaid to all individuals up to 138% of FPL (2010).

  • CT has decided to expand Medicaid (HUSKY D).

For a single adult, annual income limits will go from ~$6093 to ~$15,202. This will capture ~40,000 people.

Changes to Medicaid:
help from the government

Individuals and families may qualify for assistance from the federal government in purchasing health insurance (2014).

Help from the Government:
health insurance exchange

CT is setting up a state health insurance exchange, which will be a marketplace for individuals and families to purchase health insurance (2014).

Health Insurance Exchange:

OCTOBER 1, 2013

changes to medicare

Preventive care is now included, including an annual wellness visit (2011).

  • Additional help with prescriptions has been added and the donut hole will be closed by 2015.
  • New initiatives focus on community-based care, transitions from hospitals (2011).
Changes to Medicare:
impact on health centers nationally

$11 Billion in new health center funding over 5 years

  • New health centers
  • Expanded capacity
  • Infrastructure improvements
Impact on Health Centers (Nationally):
impact on health centers

$1.5 Billion to National Health Service Corps to help place primary care providers in shortage areas. This includes every federally-qualified health center!

Impact on Health Centers:
impact on health centers1

$150 Million to all 330-funded FQHCs to assist with outreach and enrollment for the Exchanges

  • Almost $1.6M for CT health centers
  • 72 Certified Application Counselors (CACs) currently doing enrolling at health centers; 39 additional will be online within a few weeks.
Impact on Health Centers: