A Presentation of the Colorado Health Institute 303 E. 17 th Avenue, Suite 930 Denver, Colorado (Twitter) Health Insurance Exchanges Sponsored by CO AHEC Program and Central CO AHEC Presentation : Health Insurance Exchanges by Joan Henneberry, CO Health Institute Date: 2/2/2011 Meeting AHEC/CHI

Agenda for presentation 1.Welcome 2.Introduction to keypads 3.Questions Central AHEC and COAHEC – Demographics and attitudes about the health care system and federal reforms 4.Health Insurance Exchanges 1

Simply push the key that corresponds with your answer choice It will turn on when you push a numbered key Using your Keypads 2

Your answer will be displayed on the keypad. Let’s say you press 2/B on your keypad: The check mark indicates the answer was received properly. Polling Open Note: after your selection is displayed the screen will go blank 3

As long as Polling is Open, you can change your answer by pressing any other key. Polling Open 4

What is your general view of the healthcare legislation Congress passed earlier this year? 5 1.Love it 2.Hate it 3.Mixed emotions 4.Need more information in order to understand it 5.Other

Demographic questions Who is in the room? 6

What is your race/ethnicity? American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Hispanic Unknown More than one race Other 7

What is your gender? 1.Male 2.Female 8

What is your age range? 1.<20 years old 2.20 to 29 years old 3.30 to 39 years old 4.40 to 49 years old 5.50 to 59 years old 6.>60 years old 9

I live in: 1.Denver Metro 2.Front Range 3.Northeast 4.Southeast 5.Mountain 6.San Luis Valley 7.Western Slope 8.Other 10

Are you a… 1.Native of [this town/ county/region]? 2.Native of Colorado? 3.Native of another U.S. state? 4.Native of another country? 11

A Presentation of the Colorado Health Institute 303 E. 17 th Avenue, Suite 930 Denver, Colorado (Twitter) Health Insurance Exchanges Joan Henneberry Date 2/2/2011 Meeting AHEC/CHI 12

Affordable Care Act The Patient Protection and Affordable Care Act (H.R. 3590) was signed into law on March 23, 2010 by President Obama. Provisions can be categorized into 4 broad buckets: – Medicare Reform – Insurance Reform – Medicaid Reform – Other Provisions 13

Insurance Reforms All U.S. Citizens are required to have qualifying health care coverage by Requires guarantee issue and renewability, prohibits pre-existing condition exclusions. Prohibits lifetime limits on the dollar value of coverage. Provides dependant coverage for children up to age 26. Creates a temporary national high-risk pool for individuals with pre-existing conditions, effective through January 2014; enrollment began 7/6/10 Creates temporary reinsurance program for plans that cover high-risk individuals, apps accepted 7/1/10 14

Medicaid Reform Medicaid is expanded to all individuals with incomes up to 133% FPL. All newly eligible adults are guaranteed a benchmark benefit package that provides at least essential health benefits. Federal funding for newly eligible: – 100% from 2014 through 2016 – 95% in 2017 – 94% in 2018 – 93% in 2019 – 90% in 2020 and thereafter 15

The Exchange Creates state-based American Health Benefit and Small Business Health Options Program (SHOP) Exchanges through which individuals and small businesses can purchase qualified coverage. Individuals between 133%-400% FPL receive federally financed premium credits to purchase insurance through the Exchanges, as well as cost- sharing credits. Eligibility for subsidies and public coverage based on Modified Adjusted Gross Income (MAGI), which conforms to income tax definitions. 16

Exchange Administrative Functions Eligibility, Verification, Enrollment – Coordination with Medicaid – Referrals to other programs – Coordination with IRS State-of-the-art virtual customer service – Website – Call Center Standards for plans and networks Back room functions – Reporting, program integrity, exchange of funding/payments 17

Coverage in Employer-Sponsored Insurance- 3,300,000 Medicaid – 1,200,000 Medicare – 1,000,000 Exchange – 300,000 18

Example of an On-line Exchange State of Wisconsin has developed a mock exchange ntroller?id=

How often do you buy something online? 21 1.None of my purchases 2.Sometimes I purchase items 3.Most of my purchases 4.All of my purchases

How will you purchase your policy? 22 1.On-line 2.Through a broker or navigator 3. Utilize both avenues

What is important to you in a policy? 23 1.Low monthly premiums 2.Low out of pocket expenditures 3.Network adequacy 4.Geographic convenience, or access to a providers Please pick 3

What is your general view of the healthcare legislation Congress passed earlier this year? 5 1.Love it 2.Hate it 3.Mixed emotions 4.Need more information in order to understand it 5.Other

Contacts Joan Henneberry Director, Colorado Health Insurance Exchange Lorez Meinhold Health Reform Implementation Coordinator 19