Presented by Deb Polun Director of Government Affairs/Media Relations Community Health Center Association of Connecticut

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.

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.

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

14 separate health centers Over 200 sites Over 340,000 patients Over 1.6 million visits

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

» Why did the federal government think we needed health reform?

» Improving the health of Americans » Integrating health care » Controlling health care costs

» Signed into law on March 23, 2010 » Immediately challenged by a number of states and the National Federation of Independent Business

» 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

» 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.

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

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”)

» 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).

» 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).

» 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).

» 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).

» 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.

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

» CT is setting up a state health insurance exchange, which will be a marketplace for individuals and families to purchase health insurance (2014). OCTOBER 1, 2013

» 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 » New initiatives focus on community- based care, transitions from hospitals (2011).

$11 Billion in new health center funding over 5 years » New health centers » Expanded capacity » Infrastructure improvements

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

$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.

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