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Community Health Initiative of Kern County Health Care Reform OBAMACARE The New Health Law.

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Presentation on theme: "Community Health Initiative of Kern County Health Care Reform OBAMACARE The New Health Law."— Presentation transcript:

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2 Community Health Initiative of Kern County Health Care Reform OBAMACARE The New Health Law

3 Community Health Initiative of Kern County The Patient Protection and Affordable Care Act

4 Community Health Initiative of Kern County The Patient Protection and Affordable Care Act

5 Community Health Initiative of Kern County The Patient Protection and Affordable Care Act

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7 Community Health Initiative of Kern County 1. Cannot be denied coverage due to a pre- existing condition. 2. Able to maintain coverage for young adults. 3. Ends lifetime limits on health coverage. 4. Restricts or eliminates annual limits on coverage 5. Provides preventive services at no cost.  Expanded preventive services are offered to women

8 Community Health Initiative of Kern County 6. Does not allow premium increases without justification. 7. The majority of the expenses must go towards medical costs. 8. Cannot cancel coverage due to errors on the application. 9. Requires an easy to understand explanation of benefits and coverage. 10. Essential benefits AND MORE!

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10 Community Health Initiative of Kern County Most U.S. citizens and legal residents must have health insurance or pay a fine.

11 Community Health Initiative of Kern County 201420152016 For every uninsured adult$95$325$695 For every uninsured child$47.50$162.50$347.50 Or a percentage of your income, whichever is greater 1%2%2.5%

12 Community Health Initiative of Kern County Who is exempt? Persons with a religious objection Undocumented immigrants Incarcerated persons Members of Indian Tribes If your household income is so low that you are not required to file an income tax return If buying health insurance is too expensive

13 Community Health Initiative of Kern County There are options!

14 Community Health Initiative of Kern County My employer offers me health insurance.

15 Community Health Initiative of Kern County My employer does NOT offer me health insurance and My total household income is less than 138% of the Federal Poverty Level 138% of the Federal Poverty Level

16 Community Health Initiative of Kern County My employer does NOT offer me health insurance and My total household income is less than 400% of the Federal Poverty Level 400% of the Federal Poverty Level

17 Community Health Initiative of Kern County My employer does NOT offer me health insurance and My total household income is more than 400% of the Federal Poverty Level 400% of the Federal Poverty Level

18 Community Health Initiative of Kern County Who is exempt? Persons with a religious objection Undocumented immigrants Incarcerated persons Members of Indian Tribes If your household income is so low that you are not required to file an income tax return If buying health insurance is too expensive

19 Community Health Initiative of Kern County My employer offers me health insurance. Coverage must be: 1.Affordable 2.Adequate

20 Community Health Initiative of Kern County My employer offers me health insurance but the coverage is NOT ADEQUATE. (on average, it pays less than 60% of medical costs)

21 Community Health Initiative of Kern County My employer offers me health insurance but the coverage is NOT AFFORDABLE. (I have to pay more than 9.5% of my income in premiums)

22 Community Health Initiative of Kern County Your options: 1. Employer sponsored health insurance 2. Medi-Cal 3. Covered California with Premium Assistance 4. Covered California without Premium Assistance Enrollment closes March 31 st, 2014

23 Community Health Initiative of Kern County 661-632-5018

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25 Community Health Initiative of Kern County EXPANDED PREVENTIVE SERVICES FOR WOMEN Anemia screening Breast Cancer Genetic Test Counseling Breast Cancer Mammography screenings Cervical Cancer screening Contraception Domestic and interpersonal violence screening Gestational diabetes screening HIV screening and counseling Osteoporosis screening Tobacco Use screening and intervention

26 Community Health Initiative of Kern County ESSENTIAL HEALTH BENEFITS Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services including behavioral health treatment Prescription drugs

27 Community Health Initiative of Kern County ESSENTIAL HEALTH BENEFITS Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services including:  Oral Care  Vision Care

28 Community Health Initiative of Kern County MEDI-CAL Family SizeAdults (138%) Children (250%) 1$15,971$28,725 2$21,559$38,775 4$32,582$58,600 7$47,361$89,025

29 Community Health Initiative of Kern County COVERED CA WITH PREMIUM ASSISTANCE Family SizeHousehold Income up to: 1$45,960 2$62,040 4$94,200 7$142,440

30 Community Health Initiative of Kern County COVERED CA WITHOUT PREMIUM ASSISTANCE Family SizeHousehold Income Greater than: 1$45,961 2$62,041 4$94,201 7$142,441


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