April 2013 Presented by: Ed Kiryczun Health Care Reform

How Is Access to Health Care Changing? Low and Medium income families will have access to more affordable Health Care Coverage Medi-Cal is being expanded and simplified Health Insurance Plans are accessible at lower costs And - for many low income individuals and families the premiums can be off-set by subsidies Moderate income individuals can access more complete and affordable coverage also

Changes to Medi-Cal Medi-Cal will be based on income –Up to 138% FPL –Legal Permanent Resident –No asset test Applying for and staying on Medi-Cal is streamlined –Income Based on MAGI (Modified Adjusted Gross Income) –Verified electronically when possible –Create “administrative” Renewal process Adds non-disabled adults without dependants as a new, mandatory coverage group

Health Care Coverage for those making above 138% FPL HealthCare Exchange – Covered California Offers: Advanced Premium Tax Credit (APTC) to purchase insurance policies –Subsidize for % FPL –Uses new Modified Adjusted Gross Income (MAGI) –Subsidize based on “Sliding scale” Unsubsidized coverage at affordable rates –For those making 401% FPL and higher

No wrong door HSA –Walk in, Mail in, Call or go-on line –Will screen and enroll in any of the coverage programs –Responsible for Medi-Cal application processing and case maintenance Covered California –Apply on line or over the phone for Health Coverage programs –CC network of assistors and navigators –Responsible for APTC and Unsubsidized applications and case maintenance –Those found Medi-Cal eligible forwarded to County for processing

Integrating Programs helps address family's needs comprehensively Nearly everyone eligible for CalFresh will be eligible for Medi-Cal Most newly eligible for MAGI-based Medi-Cal will be eligible for CalFresh Opportunities to integrate across other programs –CalWORKS –Employment and Vocational Services –Children and Family Service –Shelters, etc. Opens “gateway” for many to Behavioral Health Services and Substance Abuse Services

Implementation: Key Dates April – October HSA develops policies and procedures for new programs September – HSA Community Partners Health Care Reform Eligibility Forum October 1 – Open Enrollment for APTC and Unsubsidized program opens (ends March 31, 2014) January 1, 2014 – New Medi-Cal rules take effect

Thank you!