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Presentation on theme: "Health Insurance Exchanges https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html."— Presentation transcript:

1 Health Insurance Exchanges https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

2 Health care reform - United States 1 The law includes health-related provisions to take effect over the next four years, including expanding Medicaid eligibility for people making up to 133% of the federal poverty level (FPL), subsidizing insurance premiums for people making up to 400% of the FPL ($88,000 for family of 4 in 2010) so their maximum out-of-pocket payment for annual premiums will be from 2% to 9.5% of income, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre- existing conditions, establishing health insurance exchanges, prohibiting insurers from establishing annual coverage caps, and support for medical research https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

3 Affordable Care Act - Overview of provisions 1 * #Insurance exchanges and the individual mandate|Health insurance exchanges will commence operation in every state https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

4 Affordable Care Act - Change in number of uninsured 1 Starting January 1, 2014, state health insurance exchanges will be required to offer a child-only coverage option, and Medicaid eligibility will be made available to 16 million individuals with incomes below 133% of the federal poverty level. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

5 Affordable Care Act - Insurance exchanges and the individual mandate 1 The Act establishes state-based health insurance exchanges. The exchanges are regulated, online marketplaces, administered by either federal or state government, where individuals and small business can purchase private insurance plans starting October 1, 2013, with coverage beginning January 1, 2014. Individuals with incomes between 100% and 400% of the federal poverty level who purchase insurance plans via an exchange will be eligible to receive federal subsidies to help pay premium costs. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

6 Health insurance in the United States - Reform 1 The Affordable Care Act of 2010 was designed primarily to extend health coverage to those without it by expanding Medicaid, creating financial incentives for employers to offer coverage, and requiring those without employer or public coverage to purchase insurance in newly created state-run health insurance exchanges https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

7 Health insurance exchange - Background 1 Health insurance exchanges in the United States are intended to help insurers comply with consumer protection laws, compete in cost-efficient ways, and expand insurance coverage to more people https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

8 Health insurance exchange - History 1 The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23, 2010. The law required that health insurance exchanges commence operation in every state on October 1, 2013. In the first year of operation, annual enrollment|open enrollment on the exchanges runs from October 1, 2013, to March 31, 2014, and insurance plans purchased by December 15, 2013, began coverage on January 1, 2014. For 2015 open enrollment will begin November 15, 2014 and end on January 15, 2015. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

9 Health insurance exchange - Subsidies 1 Department of Health and Human Services (HHS) and Internal Revenue Service (IRS) on May 23, 2012, issued joint final rules regarding implementation of the new state-based health insurance exchanges to cover how the exchanges will determine eligibility for uninsured individuals and employees of small businesses seeking to buy insurance on the exchanges, as well as how the exchanges will handle eligibility determinations for low-income individuals applying for newly expanded Medicaid benefits https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

10 Health insurance exchange - First week of operation 1 On the date the Patient Protection and Affordable Care Act of 2010 was enacted, only a few health insurance exchanges across the country were up and running https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

11 Patient Protection and Affordable Care Act - Overview of provisions 1 * #Insurance exchanges and the individual mandate|Health insurance exchanges operate as a new avenue by which individuals and small businesses in every state can compare policies and buy insurance (with a government subsidy if eligible) https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

12 Health care in the United States - Reform 1 The law includes a large number of Provisions of the Patient Protection and Affordable Care Act|health-related provisions to take effect over the next four years, including expanding Medicaid eligibility for people making up to 133% of federal poverty level|FPL, subsidizing insurance premiums for peoples making up to 400% of federal poverty level|FPL ($88,000 for family of 4) so their maximum out-of-pocket pay will be from 2% to 9.8% of income for annual premium, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre-existing conditions, establishing health insurance exchanges, prohibiting insurers from establishing annual spending caps and support for medical research https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

13 United States federal government shutdown of 2013 1 The health insurance marketplace|health insurance exchanges created by the Affordable Care Act launched as scheduled on October 1 https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

14 United States federal government shutdown of 2013 - End of shutdown and temporary debt limit suspension 1 Despite Republican efforts to strip the Affordable Care Act of funding or delay the law as part of a deal to reopen the government, the Senate plan's only concession to the Republican leadership on the issue was stricter income verification rules for citizens accessing the health insurance exchanges https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

15 President Obama - Health care reform 1 The Patient Protection and Affordable Care Act|ACA includes Provisions of the Patient Protection and Affordable Care Act|health-related provisions to take effect over four years, including expanding Medicaid eligibility for people making up to 133% of the federal poverty level (FPL) starting in 2014, subsidizing insurance premiums for people making up to 400% of the FPL ($88,000 for family of four in 2010) so their maximum out-of-pocket payment for annual premiums will be from 2 to 9.5% of income, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre-existing conditions, establishing health insurance exchanges, prohibiting annual coverage caps, and support for medical research https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

16 Military Health System - Coverage gaps 1 Another 40.1% of veterans and 49% of their families have incomes that qualify for new subsidies through health insurance exchanges with the PPACA https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

17 Medicaid expansion - Overview of provisions 1 * #Insurance exchanges and the individual mandate|Health insurance exchanges operate as a new avenue by which individuals and small businesses in every state can compare policies and buy insurance (with a government subsidy if eligible) https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

18 Medicaid expansion - Change in number of uninsured 1 Multiple 2014 studies and surveys indicated that the number of uninsured had fallen due to expanded Medicaid eligibility and health insurance exchanges established due to PPACA https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

19 Access Health CT - Background 1 Health insurance exchanges were established as a part of the 2010 Patient Protection and Affordable Care Act to enable individuals to purchase health insurance in state-run marketplaces. In this legislation, states could choose to establish their own health insurance exchanges; if they choose not to do so, the federal government would run one for the state. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

20 HealthSource RI - Background 1 Health insurance exchanges were established as a part of the 2010 Patient Protection and Affordable Care Act to enable individuals and businesses to purchase health insurance in state-run marketplaces. Under this legislation, states could choose to establish their own health insurance exchanges; if they chose not to do so, the federal government runs one for the state. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

21 Health insurance coverage in the United States 1 Multiple surveys indicate the number of uninsured has fallen due to expanded Medicaid eligibility and health insurance exchanges established due to the Patient Protection and Affordable Care Act, also known as PPACA or Obamacare https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

22 Health insurance coverage in the United States - Estimates of the number uninsured 1 Gallup estimated in July 2014 that the uninsured rate for adults (persons 18 years of age and over) was 13.4% as of Q2 2014, down from 18.0% in Q3 2013 when the health insurance exchanges created under the Patient Protection and Affordable Care Act (PPACA or Obamacare) first opened. The uninsured rate fell across nearly all demographic groups.[http://www.gallup.com/poll/172403/un insured-rate-sinks-second-quarter.aspx In U.S., Uninsured Rate Sinks to 13.4% in Second Quarter-July 10, 2014] https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

23 DC Health Link 1 As of January 10, 2014, DC Health Link had enrolled 3,646 people in individual or family insurance plans. The District has had more success than the states' health insurance exchanges in signing up young people. Many members of Congress are enrolled in DC Health Link. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

24 Public health insurance option - History 1 and the public option was never included in the final Senate bill, instead opting for state-directed Health insurance marketplace#Health insurance exchanges in the Patient Protection and Affordable Care Act.28ACA.29|health insurance exchanges.Bankrate: [http://www.bankrate.com/finance/insuranc e/key-details-of-health-reform-bills-1.aspx Key details of health reform bills] https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

25 Public health insurance option - Alternative plans 1 The final bill, the Patient Protection and Affordable Care Act, included provisions to open health insurance exchanges in each state by October 1, 2013. As the Act requires Americans to purchase health insurance, the federal government will offer subsidies to Americans with income levels up to four times the federal poverty level.CNN: [http://money.cnn.com/2013/06/21/news/econ omy/obamacare-outreach/index.html The marketing of Obamacare exchanges begins.] June 21, 2013. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

26 Romneycare 1 As such it is one of the models of the Affordable Care Act's health insurance exchanges https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

27 Provisions of the Patient Protection and Affordable Care Act - Effective October 1, 2013 1 Open enrollment through the health insurance exchanges ends on March 31, 2014, after which time uninsured individuals generally may not purchase insurance through an exchange until the following open enrollment period https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

28 Provisions of the Patient Protection and Affordable Care Act - Effective January 1, 2014 1 Department of Health and Human Services (HHS) and Internal Revenue Service (IRS) on May 23, 2012, issued joint final rules regarding implementation of the new state- based health insurance exchanges to cover how the exchanges will determine eligibility for uninsured individuals and employees of small businesses seeking to buy insurance on the exchanges, as well as how the exchanges will handle eligibility determinations for low-income individuals applying for newly expanded Medicaid benefits https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

29 Provisions of the Patient Protection and Affordable Care Act - Effective January 1, 2014 1 * Two federally regulated multi-state plans (MSP)—one of which must be offered by a non-profit insurer, and the other cannot cover abortion services—become available in a majority of state health insurance exchanges https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

30 Provisions of the Patient Protection and Affordable Care Act - Effective January 1, 2017 1 * The two federally regulated multi-state plans (MSPs) that began being phased into state health insurance exchanges on January 1, 2014, become available in every state. https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

31 Annual enrollment 1 The term also applies to the annual period during which individuals may buy individual health insurance plans through the online, state-based health insurance exchanges established by the Patient Protection and Affordable Care Act https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

32 Health care reform debate in the United States - Similarities between the House and Senate Bills 1 * Establish health insurance exchanges making easier price and coverage comparisons and purchasing for people and small businesses buying health care coverage https://store.theartofservice.com/the-health-insurance-exchanges-toolkit.html

33 For More Information, Visit: https://store.theartofservice.co m/the-health-insurance- exchanges-toolkit.html https://store.theartofservice.co m/the-health-insurance- exchanges-toolkit.html The Art of Service https://store.theartofservice.com


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