1. Spiritual Care Champions March 12, 2014
THE AFFORDABLE CARE ACT
An Overview with Implications for
Catholic Systems and Spiritual Care
Spiritual Care Champions
March 12, 2014
Marcia Desmond, Vice President Public Policy
Alan Bowman, Vice President Ministry Formation

2. Spiritual Care Champions
Welcome
Acknowledgment: Steering Committee
Spiritual Care Champions: is a National Spiritual Care Collaborative
Began: “Healthcare Delivery in the 21st Century”
Conclude: “The Affordable Care Act-An Overview with Implications for Catholic Systems and Spiritual Care”

3. Reflection Catholic Health Initiatives: Sacred Stories Brief Light
Fourteenth Edition, pages 8-9
Brief Light
Jennifer Brandle, RN
Alegent Creighton Health Lasting Hope Recovery Center
Omaha, Nebraska
Questions for Reflection: Where do you find hope in your life?
Is there an area in your life that seems hopeless and needs rekindling?

4. Affordable Care Act Enacted in March 2010
Catholic Health Association Supported
Most Catholic Hospitals and Health Systems Supported
Imperfect Law But Intended to Expand Coverage to 32 Million Uninsured by 2019
Catholic Social Teaching Drove Support

5. Affordable Care Act Reasons for ACA Support:
Goal of access and coverage for all
Access to healthcare should be a right, not a privilege
Easing of human suffering
Respect for human dignity

6. ACA Provisions – Already in Place
Young adults on parents’ plans until age 26
Medical loss ratio premium rebates
No pre-existing condition denials for children
No lifetime limits
Phase-out of annual dollar limits
Temporary pre-existing condition coverage
No rescissions
No-cost preventive care
Rapid appeals

7. ACA Provisions – Effective in 2014
Individual Mandate
No pre-existing condition denials
Online insurance marketplaces
Subsidies to purchase insurance in Exchange
Medicaid expansions
Employer mandate (delayed)

8. Affordable Care Act Still Moving Forward But Many Challenges
Disastrous Rollout of Federal Website
Problems with Some State-run Exchanges
Accuracy of Data Provided to Medicaid and Private Insurers
Cancellation of Plans
Narrowed Provider Networks

9. Affordable Care Act Still Moving Forward But Many Challenges
Court Cases
Legality of Subsidies on Federal Exchanges
Legality of Contraceptive Coverage Mandate
Continued Republican Opposition
Congressional Hearings
Repeal Votes
Public Opinion
Politics

10. Insurance Exchanges
Open Enrollment Periods 2014 Coverage Oct. 1, 2013 – March 31, Coverage: Nov. 15, 2014 – February 15, 2015

11. Make Determinations on: Medicaid/CHIP eligibility
Insurance Exchanges
Make Determinations on:
Medicaid/CHIP eligibility
Premium Subsidies for Private Coverage
Sliding Scale 100% - 400% FPL
400% FPL = $95,400 for family of 4
Co-insurance Assistance for Private Coverage
Sliding Scale 100% - 250% FPL
250% FPL = $59,625 for family of 4

12. Insurance Exchanges
36 run by Federal Government
14 run by States
All accessible through

13. Insurance Exchanges
Private Plan Enrollment
7 Million Initial Goal for 2014
4 Million Signed up through Feb. 25, 2014
82% Eligible for Financial Assistance
Open Enrollment closes March 31, 2014

14. Medicaid Expansion
8.9 Million individuals determined eligible for Medicaid since Oct. 1, 2013
Medicaid enrollment can continue all year through State agencies
Medicaid expansion to 138% FPL is state option

16. Role for Catholic Hospitals and Health Systems
Outreach and Enrollment Efforts
Education of Caregivers
Assistance for Patients and Families
Community Outreach
Medicaid Presumptive Eligibility – Effective January 1, 2014 in all States

17. Medicaid Presumptive Eligibility
Hospitals can temporarily enroll patients and families in Medicaid using vastly simplified application
Hospital obtains basic information on individual, monthly income and household size
If appear eligible for Medicaid, immediately enroll for temporary period
Patient follows up with full Medicaid application within 1 month
Temporary coverage lasts until full determination made
Hospital gets paid while patient temporarily enrolled, regardless of final determination on Medicaid application

18. Opportunities for Spiritual Care
Four Key Facts to Share with
Patients and Families:
All plans must cover the care you need, including doctor visits, hospital stays, preventive care, prescriptions, and more.
Low-cost and free plans are available, and financial help is available based on how much money you make.
No one can be denied coverage or charged more because they have a pre-existing condition.
There is no sales pitch or fine print, just side-by-side comparisons of each plan.

19. Opportunities for Spiritual Care
Tell People Where to Go for More Information!
Online:
Phone:
In Person: Provide contact information for
enrollment assistance within your
hospital or health system

20. Spiritual Care Can Impact & Improve:
Health outcomes: a pastoral example
Pain management: a pastoral example
Employee engagement
Quality and HCAPS: Hospital Consumer Assessment of Healthcare Providers and Systems
Efficiency and financial outcomes
Wellness and preventative care
The health of the communities we serve

21. Opportunity for Dialogue Questions and Feedback
Where can you make a difference? Reminder the SCC begins on April 23 with a presentation on “Change Agent” If you have any questions or concerns, please us at
Questions and Feedback